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UNITED STATES OF AMERICA, 



AN 

OBSTETRIC MENTOR 

A HANDBOOK OF HOMOEOPATHIC TREATMENT 
REQUIRED DURING 

Pregnancy, Parturition, and the. 
Puerperal Season, 



CLARENCE M. CONANT, M. D., 

Author of "Repertory," Lilienthal's Skin Diseases, Member of the 
American Institute of Homoeopathy, &c, &c. 






NEW YORK : 
A. L. CHATTERTON PUBLISHING CO., 

1884. 






Copyright, 1883. 

BY 

A. L. CHATTERTON PUBLISHING CO. 



W. L. Mershon & Co., 

Printers, Electrotypers and Binders. 
Rahway, N. J. 



PREFACE. 



The design of this little compilation originated in 
this wise. Frequently perplexed in prescribing for 
pregnant and parturient women, we have rushed 
from the bedside to the office, and after hunting 
through a dozen or more authorities, gone back to 
the patient, prescribed and succeeded. The first 
idea was, a case in which to carry Guernsey's Ob- 
stetrics and have it always in the conveyance ; but 
the amended thought was, " suppose the cream of 
our therapeutics divested of all other matter, and 
culled from every available source, in so small a 
compass as to be pocketable ! " The tangible 
expression of the idea is before you, and while we 
do not hope but that omissions and errors have 
been made, we do hope that none will be found 
which are very vital. Corrections and additions 
will be thankfully received by the compiler. 

We must acknowledge assistance and advice from 
several members of the profession ; and especially 
we extend thanks to Selden H. Tal-cott, M. D., 
Superintendent of the State Homoeopathic Asylum 
for the Insane in this town, for suggestions regard- 
ing the treatment of puerperal insanity. 



PREFACE. 13 

In compiling this reminder the following authori- 
ties have been scrutinized : 

Guernsey's Obstetrics. 

Leavitt's " 

Richardson's " 

Croserio's 

Marsden's Practical Midwifery. 

Jahr's Diseases of Females. 

Hale on Diseases of Women. 

Ludlam 

Eaton 

Eggert's Uterine and Vaginal Discharges. 

Lilienthal's Homoeopathic Therapeutics. 

Ostrom on the Breast. 

Hart on Diseases of the Nervous System. 

Bell on Diarrhoea. 

Allen & Norton's Ophthalmic Therapeutics. 

King on Headache. 

Johnson's Therapeutic Key. 

Hale's New Remedies. 

Jahr's Manual. 

Dunham's Lectures on Materia Medica. 

Raue's Record of Homoeopathic Literature. 

Files of The Homoeopathic Journal of Obstetrics. 
" The Hahnemannian Monthly. 
" The Medical Counselor. 

The American Homoeopath and 

The Transactions of the American Institute of 
Homoeopathy, and of the New York State Homoeo- 
pathic Medical Society. 

CLARENCE M. CONANT. 

MlDDLETOWN, N. Y. , 1883. 



CHAPTER I. 

Variations of Appetite — Gastroses — Enteric 
Diseases — Hepatic Troubles. 

Not infrequently the first intimation of the exis- 
tence of pregnancy is an extraordinary capricious- 
ness of appetite. There may be loss of appetite in 
general, or aversion to particular things; or there 
may be great increase of appetite, or merely craving 
for special articles of diet. Along with these con- 
ditions, or independent of them, the sense of taste 
may be perverted. As to increase of appetite, we 
will remark, in passing, that where it exists in preg- 
nant women otherwise in health, it is usually a good 
sign, and, within reasonable limits, should be in- 
dulged, and not checked as is sometimes done. 

Variations of Appetite and Taste. 

Anorexia: Chin., Cycl., Nux. v., Rhus tox., Sep. r 
Sil. 

Bulimy: Calc. carb., Chin., Cina., Iod., Lye, Nux 
v., Puis., Sil., Verat. alb. 

Hunger, without Appetite: Bry., Nat. mur., Op.. 
Rhus tox. 

Thirst: Aeon., Ars., Bry., Calc. carb., Cham., 
Chin., Merc, sol., Sulph., Verat. alb. 

Adipsia: Apis., Ferr. acet., Gels., Hell., Merc, sol., 
Nux mos., Puis., Sarsap. 



1 6 AN OBSTETRIC MENTOR. 

Thirst, with Aversion to Drink: Bell., Canth., 
Hyosc, Nux v., Stram. 

Aversion to Acid Food: Bell., Coca, Ferr., Sabad., 
Sulph. 

Aversion to Beer: Bell., Chin., Coca, Nux v., 
Stann., Sulph. 

Aversion to Brandy: Ign., Merc. sol. 

Aversion to Bread generally: Con., Nat. mur., 
Puis., Sep., Sulph. 

Aversion to Rye Bread: Lye, Nat. mur., Nux v., 
Phos. ac., Sulph. 

Aversion to Broth (Meat): Arn., Ars., Graph. 

Aversion to Butter: Carbo veg., Chin., Merc. sol. 

Aversion to Coffee: Bry., Calc. carb., Cham., 
Coff., Nux v., Phos., Rhus tox. 

Aversion to Fat Food: Bry., Carbo an., Carbo 
veg., Cycl., Nat. mur., Petr., Puis. 

Aversion to Fish: Graph., Zinc. 

Aversion to Meats: Calc. carb., Carbo veg., 
Graph., Lye, Mur. ac., Nitr. ac., Petr., Rhus tox., 
Sabad., Sep., Sil., Sulph. 

Aversion to Flour and Meal (Dishes made of): 
Phos. 

Aversion to Milk: Bry., Calc. carb., Guaj., Puis., 
Sep., Sil., Sulph. 

Aversion to Salt Food: Carbo veg., Selen. 

Aversion to Solid Food: Ang., Bapt., Bry., Ferr., 
Staph., Sulph. 

Aversion to Sweet Food: Caust., Sulph. 

Aversion to Vegetables: Hell., Magn. carb. 

Aversion to Water: Bell., Calad., Nux v., Stram. 

Aversion to Wine: Merc, sol., Sabad. 

Desire for Acids: Ant. crud., Ars., Bry., 
Cham., Hep., Lach., Phos., Strain., Sulph., Verat. 
alb. 



AN OBSTETRIC MENTOR. 1 7 

Desire for Beer: Bry., Merc, sol., Nat. carb., Nux 
v., Op., Petr., Puis., Sabad., Stront. 

Desire for Bitter Things: Digit., Nat. raur. 

Desire for Bread: Ars., Plumb. 

Desire for Brandy: Ars., Hep., Lach., Nux v., Op., 
Selen., Sep., Sulph. 

Desire for Coal, Chalk, Slate, etc.: Cic, Nitr. ac, 
Nux v. 

Desire for Cake: Plumb. 

Desire for Cheese: Ignat. 

Desire for Coffee: Ang., Aur., Bry., Chin., Con., 
Selen. 

Desire for Fat Food: Nux v., Nitr. ac, Thuja. 

Desire for Fruit: Ign., Sulph. ac, Verat alb. 

Desire for Juicy Things: Phos. ac. 

Desire for Soup and Broth: Ang., Ferr., Staph., 
Sulph. 

Desire for Meat: Magn. carb., Merc, sol., Sulph. 

Desire for Meal and Flour (Dishes made of): 
Sabad. 

Desire for Milk: Aur., Chel., Merc, sol., Sabad., 
Sil. 

Desire for Raw Potatoes and Flour : Calc 
carb. 

Desire for Salt Things: Calc. carb., Caust., Con., 
Nitr. ac, Verat. alb. 

Desire for Smoked Food: Caust. 

Desire for Sourkraut: Carbo an. 

Desire for Sweet Things: Aram, carb., Chin., 
Kali carb., Lye, Nat. carb., Rhus tox., Sabad. 

Desire for Vegetables: Alum, Magn. carb. 

Desire for Warm Food: Ferr., Lye 

Desire for Wine: Cic, Hep., Sep., Sulph. 

Taste: i. Bitter. — Aeon., Bry., Calc. carb., Cham., 
Merc sol., Nux v., Puis., Sep., Sil., Sulph., Verat alb. 



1 8 AN OBSTETRIC MENTOR. 

2. Lost or Diminished: Nat. mur., Puis., 
SiL 

3. As of Blood: Ipec, Sulph. 

4. Empyreumatic: Puis., Sulph. 

5. As of Pus: Puis. 

6. Like Clay: Chin., Hep., Puis. 

7. Flat, Watery, Insipid: Bry., Caps., 
Chin., Ipec., Puis., Rhus tox., Sulph. 

8. Foul, Putrid, Offensive: Aeon., Am., 
Bell., Bry., Cham., Merc, sol., Nat. mur., Puis., Rhus 
tox., Sulph., Verat. alb. 

9. Oily, Greasy: Caust, Sil., Valer. 

10. Metallic: Cupr., Nux v., Rhus tox. 

11. Slimy, Viscid: Arn., Bell. 

12. Rancid: Asaf., Bry., Mur. ac, Nux v., 
Petr., Puis., Sulph. 

13. Salty: Ars., Carbo veg., Merc, sol., 
Nat. mur., Nux v., Phos., Puis., Sep., Sulph. 

14. Sour: Bell., Calc. carb., Chin., Coca, 
Cupr., Nux v., Phos. ac, Puis., Sulph., Tarax. 

15. Sweetish: Bell., Bry., Chin., Cupr., 
Ferr., Merc, sol., Phos., Plumb., Puis., Sabad., Squill., 
Sulph. 

Food Tastes badly: a. Bitter: 
Ferr., Hep., Rhus tox., Sulph. 

b. Salt: 
Sulph. 

c. Sour: 
China. 

Bread Tastes sweet: Merc. sol. 

Beer Tastes Sweet: Puis. 

In Morning Taste Sour: Nux v., Sulph. 

" Bitter: Arn., Puis. 

" Foal: Rhus tox., Sulph 

" Sweet: Sulph. 



Bry., 


Coloc, 


Carbo 


veg., 


Calc. 


carb., 



a 


a 


u 


u 


u 


a 



AN OBSTETRIC MENTOR. 19 

Sour Taste: a. After Eating: Carbo veg., Cocc, 
Nat. mur., Nux v., Puis., Sil. 

b. After Drinking: Nux v., Sulph. 

c. After Drinking Milk: Carbo 
veg., Sulph. 

Food and Drink Taste Bitter: Chin., Puis. 
Bitter Taste after Eating and Drinking: Ars., 
Bry., Puis. 

Morning Sickness, Nausea and Vomiting. 

First, compare: Cocc, Ipec, Kali carb., Kreas., 
Lact. ac, Lobel. infl., Nux v., Petr., Puis., Tart, em., 
Tabac, A^erat. alb. 

Cocculus : Naitsea felt in head. Inclination to 
vomit in morning on attempting to rise, which at- 
tempt makes her faint. Worse from riding in a car- 
riage or sailing. Yellow tongue and aversion to 
food. 

Ipecac : Incessant nausea; not a moment's relief. 
Cutting pain about umbilicus. Great uneasiness in 
stomach. Vomiting great quantities of mucus, of 
sour or undigested food, of bilious matter, with colic 
and diarrhoea. 

Kali carb.: Nausea, without vomiting, coming 
on only during a walk; feeling as if she would like 
to lie down any where and die. Swoon-like failure 
of strength while vomiting. Very sleepy while eat- 
ing. Stitching pains in abdomen. 

Kreas.: Vomiting of sweetish water before 
breakfast, breakfast and dinner being retained. 
Vomiting after supper. 

Lactic ac: Sour, taste and vomiting of sour 
matter. Faintness in stomach and diarrhoea. 

Lob. inflat.: Nausea and vomiting, with pro 



20 AN OBSTETRIC MENTOR. 

fuse running of water from the mouth ; worse at 
night and after sleeping, and relieved by a little food 
or drink. After vomiting, breaks out in a sweat, 
followed by sensation as of needles pricking her all 
over. Asthmatic sufferings. 

Nux v.: Nausea and vomiting in morning after 
eating. Thinks she would feel better if she could 
votnit. Food and drink smell bad to her, and she 
cannot bear the odor of tobacco. Bitter or sour 
taste, belching, eructations, hiccoughing, and heart- 
burn. Vomiting of food, bile, of black or sour mat- 
ter, and of sticky mucus. Restless sleep, particularly 
after 3 a.m. Great depression and irritability. She 
wants to be alone and let alone, and will not talk. 
Constipation ; large, difficult faeces. 

Petrol.: Vomiting of bile. Aversion to fat food 
and meat. Nausea worse while riding in a carriage. 
Diarrhoea only in daytime. Particularly applicable 
to all the gastroses of pregnant women. 

Puls. : Excessively bad taste in mouth in morning, 
but nausea and vomiting in evening and at night. 
Vomiting at night, with flatulent colic ; of green slimy, 
bilious masses ; nausea and colic after vomit- 
ing, and are followed by diarrhoea of changeable 
stools, of white, green, or yellow mucus. Percepti- 
ble pulsations in the pit of the stomach. Loss of 
thirst and taste : water is repugnant ; things taste 
bitter, fatty, salt, sour, or sweet. Eructations tast- 
ing of the food recently eaten. 

Tart, em.: Vomiting of large quantities of 
mucus in a most violent manner. Belching and 
disgust for food. Salivation. 

Tabac: Nausea, with deadly faintness and pallor 
of the face, relieved by going into the open air. 
Nausea on beginning to move. She gets very thin 



AN OBSTETRIC MENTOR. 21 

rapidly, and vomits water or acid liquids or 
mucus. 

Verat. alb.: Violent and profuse vomiting of 
egesta and bile. Cold sweat on forehead. Desire for 
fruit and juicy things, for acids and salt food, for 
cold food. Canine hunger. Feels very weak and 
faint. 

Second, study also: Alet. far., Anac, Ant. crud., 
Ars., Bry., Carb. ac, Con., Cycl., Cupr. ars., 
Ferr. acet., Gossyp., Nat. mur., Nitr. ac, Phos., 
Sep., Sil., Staph. 

Alet. far.: Nausea with vomiting, with indi- 
gestion and debility. The least food causes distress 
in stomach. Frequent faintings, with vertigo. 
Sleepy all the time. Emaciation. Constipation. 

Anacard.: Morning nausea. Empty feeling in 
stomach. Nausea worse before and after eating ; 
better while eating, and after vomiting egesta. Weak 
digestion, with fullness and distention of abdomen. 

Ant. crud.: Persistent vomiting, with convul- 
sions. Milky white tongue, and eructations tasting 
of egesta ; derangements from overloading the 
stomach. Desire for acids. 

Arsen.: Vomiting after eating and drinking, and 
at night, of green or black matter. Cold water 
seems to lie in the stomach, therefore she cannot 
drink it, although greatly desired. Great weakness 
and exhausting diarrhoea. Burning pains in stomach, 
bowels, and breasts. All symptoms relieved by mov- 
ing about. Food is relished, but leaves a bitter 
taste in mouth. Aversion to meats and desire for 
fruits and vegetables. Coldness and restlessness. 

Bryon.: Nausea and vomiting worse from mo- 
tion and after eating. She desires to keep still, and 
gets marked relief by so doing. Dry lips, mouth and 



22 AN OBSTETRIC MENTOR. 

tongue, with thirst. Splitting headache. Worse 
from sitting up (even in bed) in warm air and dur- 
ing warm weather, or from warm food. 

Carbol. ac: Vomiting with frantic headache. 
Great irritability of temper, and aching in stomach. 

Conium : Terrible nausea and vomiting in women 
having scirrhosities. Vertigo while lying down or 
when turning over in bed. Swelling and soreness of 
breasts, especially when it has been habitual during 
menstruation. Intermittent urination. Eructations 
and heartburn. 

Cyclam : Wants no breakfast. After eating the 
least quantity, nausea and disgust in mouth and 
throat. Vertigo : dimness of vision, with fiery specks 
and sparks before her eyes. Intermittent thirst. 
Greasy taste, and fat food disagrees. 

Cupr. ars. : Constant nausea: vomits every- 
thing. Spasmodic uterine pains. Very weak, with 
a full, quick pulse. 

Ferr. acet. : Vomiting only after eating, with a 
fiery red face, of food ; of sour, acid matter ; of 
blood. Vomiting at midnight. Nervous erethism. 

Gossypium : Nausea before breakfast. Great 
distress, weakness, and prostration. Useful in very 
bad cases where miscarriage is threatened. 

Nat. mur.: Nausea in morning. Vomiting of 
food. Profuse, constant waterbrash, like limpid 
mucus. Obstinate cases, with loss of appetite and 
taste ; great hunger, as if stomach were empty, but 
no appetite. Heartburn after eating. Always 
awakes in morning with headache. Dreams of rob- 
bers in house, which must be searched to satisfy 
her. Palpitation of heart. 

Nitric ac: Nausea and gastric troubles better 
moving about or riding in carriage. Nausea and 



AN OBSTETRIC MENTOR. 23 

burning in the stomach and throat. Urine very 
strong and offensive, like that of horses. 

Phos. : Very sleepy, especially after dinner. Long, 
narrow, hard stools, difficult to expel. Sour eructa- 
tions and vomiting. Vomiting of food, sour matter, 
and of blood. Profuse, watery diarrhoea. Slender, 
red-haired phthisical women. 

Sepia :' Great sense of emptiness at pit of stomach. 
Nausea in morning, as if viscera were turning inside 
out. Vomiting of milky water or mucus, and of 
bile. The thought of food sickens her. Taste (and 
eructations) as of spoiled eggs or manure, and loath- 
ing of all food, especially meat. Yellowness of face, 
especially across the nose. Almost specific for con- 
stipation of pregnant women. Dunham was wont 
to call Sepia " the washerwoman's remedy," and its 
complaints are aggravated from doing laundry work. 

Silicia : Nausea and vomiting in women who 
have palpitation of heart during menstruation. 
Aversion to meat. Taste of blood in mouth in the 
morning. Nausea, with palpitation after every exer- 
cise that warms her up a little. Constipation : stool 
seems to recede after partial protrusion. 

Staph.: Extreme hunger, even when stomach 
is full of food ; sensation as if stomach hung down 
relaxed. Constant accumulation of water in mouth. 

Hygienic Measures : Advise the patient not to 
rise until she has eaten a little something and taken 
a cup of coffee (if habituated to it), or tea if pre- 
ferred ; cocoa or alkethrepta is sometimes better 
than either. Cold milk is excellent. Many kinds 
of jellies (calves-foot, beef, or wine), taken in very 
small qua?itities, are good nourishment. 

For this and the other gastric troubles of preg- 
nancy consult further the following 



24 AN OBSTETRIC MENTOR. 



Repertory of Remedies for Gastroses. 

Belching or Eructations : (Like rotten eggs 
— Arn. and Brom.) Arn., Bell., Bry., Cocc. Con., 
Merc, sol., Nux v., Phos., Puis., Rhus tox., Sarsap., 
Sep., Sulph., Sulph. ac, Tart, e., Verat. alb. 

Hiccoughing : i. Amm. mur., Cycl., Hyosc, 
Ign., Kali brom., Nux v. 2. Agar., Bell., Bry., Puis., 
Ran. bulb., Verat. alb. 

Heartburn : 1. Calc. carb., Carbo veg., Caust, 
Con., Croc, Nux v. 2. Amm. carb., Caps., Carbo an., 
Chin., Iod., Lye, Merc, sol., Nat. mur., Phos., Puis., 
Sep., Valer., Verat. alb. 

Ptyalism : Jaborandi, Kali bich., Kali iod., Merc, 
sol., Nat. mur., Puis., Sulph. 

Risings into Throat : 1. Asaf., Merc, sol., Lach., 
Plat. 2. Con., Phos., Puis., Spig., Valer., Verat. alb. 

Disgust for Food : 1. Ipec, Kali carb., Sep. 2. 
Ant. crud., Bell., Bry., Puis., Sil., Tart. e. 

Nausea Felt in Throat : 1. Cycl., Phos. ac, Stann. 
2. Cupr. met., Puis., Staph., Valer. 

Nausea Felt in Chest : Aeon., Croc, Carbo veg., 
Merc, sol., Phos., Rhus tox. 

Nausea Felt in Abdomen : Bry., Puis. 

Empty Retching, Gagging : 1. Bell., Ipec. Verat. 
alb. 2. Arn., Asar., Bry., Chin., Nux v., Puis., 
Sulph. 

Vomiting of Bile, Bitter Vomiting : 1. Ars., Bry., 
Cham., Ipec, Merc, sol., Nux v., Puis., Sep., Verat. 
alb. 2. Aeon., Bell., Chin., Con., Cupr., Dulc, 
Ignat., Lye, Petrol, Plumb., Sec, Stann., Sulph. 

Vomiting of Black Matter : 1. Ars., Cadmium 
sulph., Chin., Nux v. 2. Petr., Phos., Plumb., Verat 
alb. 



AN OBSTETRIC MENTOR. 25 

Vomiting of Blood : (Clotted — Arm, Caust.) i. 
Am., Ferr., Ipec, Phos. 2. Aeon., Canth., Chin., 
Ham., Millef., Nux v., Plumb., Puis., Sep., Sulph. 

Vomiting of Brown Matter : Ars., Bism., Mez., 
Phos. 

Vomiting Caused by Passive Motions, (Sailing, 
Riding in a Carriage, etc.) : 1. Ars., Cocc., Colch., 
Ferr., Hyosc., Petrol. 2. Bell., Croc., Nux mos., 
Sec, Sil., Staph., Sulph., Tabac. 

Vomiting Caused by Overloading Stomach, (or 
Eating Indigestible Food) : 1. Ipec, Puis. 2. Ant. 
crud., Ars., Bell., Bry., Ferr., Nux v., Rhus tox., 
Sulph. 

Vomiting Caused by moving : Ars., Bry., Nux 
v., Petrol., Verat. alb. 

Vomiting,- with Diarrhoea : Ars., Bell., Coloc, 
Cupr. met., Dulc, Ipec, Phos., Puis., Verat. alb. 
2. Apoc. and Iris. 

Vomiting of what has been Drunk : 1. Ars., Phos., 
Verat. alb. 2. Bry., Cham., Dulc, Ipec, Nux v., 
Sil., Tart. e. 

Vomiting what has been Eaten : 1. Ars., Bry., 
Ferr., Nux v., Squill. 2. Amm. Carb., Ant. crud., 
Calc carb., Cina, Cupr. met., Dros., Hyosc, Ign., 
Ipec, Lye, Nat. mur., Phos., Plumb, met., Puis., 
Sep., Stann., Sulph., Verat. alb. 

Vomiting of Foetid Matter : Sep. and Ars., Bry., 
Cocc, Carbo veg., Cupr. met., Ipec, Krea's., Nux v., 
Opium, Stann., Sulph. 

Vomiting of Greenish-Black Matter : Petrol., 
Phos., Plumb. 

Vomiting in Morning : 1. Ars., Dros., Nux v., 
Verat. alb. 2. Hep., Lye, Nat. mur., Sil. 

Vomiting at Night : Ars., Chin., Ferr-, Nux v., 
Sil., Sulph. 



26 AN OBSTETRIC MENTOR. 

Vomiting of Salty Matter : (Bitter salt — Sil.) 
Magn. carb., Puis., Sil., Sulph. 

Vomiting of Slimy Matter : i. Dros., Puis., 
Tart. e. 2. Ars., Bell., Cham., Chin., Con., Digit., 
Hyosc, Ign., Ipec, Merc, sol., Nux v., Sec, 
Sulph., Verat. alb. 

Vomiting of Sour Matter : (Bitter sour — Ipec, 
Puis., and Tart, e.) 1. Calc Carb., Chin., Lye, 
Nux v., Phbs., Puis., Sulph. 2. Ars., Bell., Cham., 
Ipec, Verat. alb. 

Vomiting of Watery Matter : 1. Bell., Bry., 
Caust., Ipec, Verat. alb. 2. Arn., Cann. sat., 
Chin., Con., Cupr. met., Nux v., Stann., Sulph. ac 

Vomiting of Worms : 1. Aeon., Cina, Ferr., 
Sabad., Sec. 2. Hyosc, Sil., Spig., Verat. alb. 

Vomiting Worse after Drinking : (When cold 
fluid gets warm in stomach — Phos.) 1. Ars., Chin., 
Ferr., Verat. alb. 2. Aeon., Arn., Bry., Cham., Nux 
v., Puis., Sil. 

Vomiting Worse after Eating : 1. Ars., Ferr., 
Ipec, Kreas., Nux v., Puis., Sulph., Verat. alb. 
2. Aeon., Arn., Hyosc, Nat. mur. 

Vomiting of Mucus, then Bile : Verat. alb. 

Vomiting of Mucus, then Food : Ars., Oleand. 

Vomiting of Food, then Bile : Nat. mur., Phos., 
Zinc 

Vomiting of Food, then Mucus : Dros., Nux v., 
Selen. 

Vomiting of Food, then Water : Ferr., Puis. 

Vomiting of Water, then Food : Ipec, Magn., 
Carb., Nux v., Sulph. 

Vomiting of Yellowish Matter : Ars., Colch. 
Iod. 



AN OBSTETRIC MENTOR. 27 



Hepatic Troubles. 



It is rare that the liver is sympathetically affected 
during pregnancy, excepting conditions causing or 
accompanying diarrhoea and constipation. For 
these, indications will shortly be given. Richard- 
son says, ." Icterus is a frequent accompaniment of 
utero-gestation," and gives indications for twelve 
remedies ; but Guernsey does not even mention it. 

Icterus during Pregnancy : i. Aeon., Bell., 
Cham., Puis., Phos., Sepia. 2. Bry., Digit., Plat., 
Pod., Sulph. 

Icterus Caused by Anger and Chagrin : Aeon., 
Cham., Chin., Ign., Nux v., Nat. mur., Sulph. 

Icterus caused by Chilling Changes of Tempera- 
ture : Cham., Dulc, Nux v. 

Icterus Caused by Overloading Stomach and Bad 
Food : Ant. crud., Bry., Carbo veg., Cham., Nat. 
carb., Nux v., Puis. 

Icterus Caused by Chamomile Tea : Chin., Ign., 
Nux v., Puis. 

Icterus Caused by Mercury : Asafcet., Ars., Chin., 
Hep., Iod., Nitr. ac, Sulph. 

Icterus Caused by Peruvian Bark*: Ars., Ipec, 
Merc, sol., Puis. 

Icterus, with much Flatulence : Carbo veg., 
Cham., Chin., Ign., Lye, Nux v., Plumb. 

Constipation. 

This condition is almost universally present dur- 
ing gestation, but is no less serious or remediable 
for that reason. Advise active (but not excessive) 
exercise in the open air, and frequent bathing of 
the whole body in cold water if it can be endured. 



28 AN OBSTETRIC MENTOR. 

Encourage the use of plenty of fruit and vegeta- 
bles (not much bread or cake), and for drinks, 
chocolate (alkethrepta better), lemonade, and cold- 
water, and not much tea and coffee. Advise fur- 
ther, and insist upon, regular times for evacuation 
and their strict observance ; and if the bowels do 
not move, let nature be assisted by an enema of 
tepid water and soapsuds. Compare for 

Constipation : i. Alumin., Bry., Lye, Nux v., 
Opium, Sep., and Sulph. 2 ^Escul. hip., Collinso., 
Hydrast., Kali c, Lach., Nat. mur., Phyt, Plumb, 
met., Puis. 

Alumina : Inactivity of rectum : it requires 
great effort to expel even a soft stool. Stool hard, 
knotty, and scanty. 

Bryonia: Stool very large and seems to tear the 
anus j very d?y, hard, and dark, as if burnt. Splitting 
headache. Very irritable and prone to fits of anger. 
Mouth and lips dry, and much thirst. Rheumatic 
diathesis. After abuse of castor-oil. 

Lycopodium : Many dyspeptic troubles. Much 
rumbling and flatulence and pain in abdomen. 
Urine very hot and smarting, and contains red sand: 
Pain in back before urination. 

Nux v. : Women of sedentary habits who eat 
high seasoned food and use wines and coffee freely. 
Much backache, and pressing and urging both to 
stool and urination. Piles, headache, and unref resh- 
ing sleep. Colicky, flatulent pains in abdomen. 
After the use of cathartics. 

Opium : Stool of hard, round, black balls, with 
paralysis of the rectum. Sleeplessness and acute 
hearing at night 

Sepia : Sensation of a lump or heavy weight in 
the anus. Stool very difficult, covered with mucus 



AN OBSTETRIC MENTOR. 29 

and sometimes cannot be voided, or is ejected with 
terrible involuntary strainings. Sepia is almost spe- 
cific for the constipation of pregnant women, but must 
be given high. Do not give it at night, for it will 
aggravate night symptoms. 

Sulphur : Flushes of head all over ; head hot 
and feet cold. Hunger and faintness between n 
a. m. and noon. Stool hard, lumpy, and striped or 
streaked with blood. The first effort at stool is so 
agonizing that she must desist. Piles, prolapsus, 
and fissure of the rectum. 

^Escul. hip.: Backache in the sacro-iliac sym- 
physes, with piles and constipation. 

Collinso.: Stool lumpy and light-colored, with 
piles and dull pains in the anus. 

Hydrast.: Headache, piles, and pains in the 
anus and rectum for hours after stool. Hughes 
says, " A precious remedy, far superior to Nux v.; " 
but we have not found it so. 

Kali carb.: Stitching pains and many bad 
feelings before stool. Rectum seems too weak to 
expel the stool. Hatulency. Violent backache. 
Bowels move every other day. Wakes every morn- 
ing at 3 a. m., and feels very badly. 

Lach. History of chronic constipation and ovari- 
an affections. The anus feels closed, and faeces 
press against it all the time without passing. 

Nat. mur. : Stool very dry and hard, Assuring 
the anus and making it bleed. Headache on wak- 
ing every morning. Desire for salt and aversion to 
bread. Dreams very vivid and fearful of robbers 
in the house, which must be searched for to satisfy 
her. 

Phytolacca: Chronic constipation, with rheu- 
matic pains in hips and thighs when the weather 



30 AN OBSTETRIC MENTOR. 

changes. Soreness of breasts and nipples. Chronic 
dry sore throat. 

Plumb, met.: Stool of small balls compacted like 
sheep-dung. Violent colic and flatulence. 

Pulsat.: Alternate constipation and diarrhoea 
caused by gastric derangement from eating rich, 
greasy food. Borborygmus and emissions of foetid 
flatus. Very nauseous taste in mouth in morning : 
she must wash it out. She has many uterine and 
back pains, and says the child turns over and does 
not lie right, so that it hurts her. 

HAEMORRHOIDS. 

Bleeding Piles : i. Aeon., Aloes, Collinso., Ha- 
mara., Millef., Nitr. ac, Nux v., and Sulp. 2. iEscul. 
hip., Bell., Calc. carb., Caps., and Puis. 

Blind Piles : 1. ^Escul. hip., Collinso., Lach., 
Mur. ac, Nux v., Podoph., Ratanh., and Sulph. 2. 
Ars., Graph., and Puis. 

Aconite: Bleeding piles in plethoric women. 
Great restlessness and uneasiness. Pain and pres- 
sure at anus and in back and abdomen, as if 
bruised. 

tEsculus hip.: Protruding piles, bleeding very 
rarely or slightly, with constipation and severe back- 
ache in the sacrum and hips, which give out when 
walking. 

Aloes : Protruding piles in a bunch, like a clus- 
ter of grapes, relieved by bathing with cold water. 
Fistula in ano. Bilious diarrhoea (which may have 
caused piles). Want of confidence in the sphinc- 
ter : it seems as if the botvels would move inhile she 
urinates. Hepatic troubles, and history of the 
same. 

Arsenic : Blind piles which burn like fire, es- 



AN OBSTETRIC MENTOR. 31 

pecially at night after midnight, with great anguish 
and restlessness. Fissures of the anus ; backache, 
as if broken. She cannot stoop. Thirst. 

Belladonna : Congestive, throbbing headache 
and nervous restlessness and insomnia, although she 
is sleepy. Spasmodic contraction of the sphincter, 
causing strangulation and excessive sensitiveness of 
the piles : she must lie with the nates separated, as 
the piles will not tolerate the least contact. Dysu- 
ria. 

Calc. carb.: Profusely bleeding, protruding 
piles. Terrible aching and shooting pains in the 
anus and rectiu?i for hours after stool. Worse when 
walking. Feet are cold and damp ; the sweat is 
ichorous and offensive, and makes the feet sore. 
Vertigo after suppression of the hsemorrhoidal flux; 
after Sulph. 

Capsicum: Bleeding piles, with burning in anus. 
Drawing pains in the back and cutting pains in the 
bowels. Very large piles in fat people easily ex- 
hausted. Suppressed flux, causing melancholy. 

Collinso. : Blind or bleeding piles, with obsti- 
nate constipation and stools only in the evening j 
sensation as if the rectum were filled with gravel or 
sand. Aggravation from evening to late at night ; 
better in the morning. 

Graphites : Blind piles, with constipation, fis- 
sures and prolapsus of the rectum. Itching blotches, 
especially on the face, which exude a sticky fluid. 
Worse at night. 

Hamamelis : Profusely bleeding piles, with ex- 
cessive soreness, and prostration out of proportion 
to the loss of blood. Backache, as if it would 
break. Haematuria, constipation, frontal headache, 
and restless nights. 



32 AN OBSTETRIC MENTOR. 

Lachesis : Piles, with chronic obstinate constipa- 
tion, and history of ovarian affections (especially left 
side). The anus feels as if filled up by the piles, so 
that nothing can pass. The piles are strangulated 
and protruding : a stitch runs through them when 
she coughs or sneezes. 

Millefolium: Profuse, bright red haemorrhages 
from the piles, which are very painful. Mucous 
piles. 

Mur. ac: Protruding, bluish, strangulated piles, 
which are excessively sensitive to contact even of the 
sheet ; violent itching. Prolapsus ani, and involun- 
tary stool while urinating. 

Nitr. ac. Old hemorrhoids bleeding profusely 
(bright red, not clotted) at every stool* which is fol- 
lowed by a sharp cutting pain in the rectum which 
lasts for hours. Worse after a loose stool. Fis- 
sures of the anus. Hematuria. 

Nux v.: Sedentary habit, after coffee and spirit- 
uous liquors. Blind or bleeding piles, with frontal 
headache and many agonizing back pains. Consti- 
pation,, with ineffectual urging, or stool in the morn- 
ing, with great aggravation of all complaints. Ir- 
ritable disposition and anorexia. 

Podoph. : Piles, with prolapsus ani (and also es- 
pecially after confinement) and morning diarrhoea or 
constipation. For this latter a high potency is in- 
dispensable. She is subject to " bilious attacks," 
and has many hepatic symptoms. 

Pulsatilla: Constipation, with stool mostly in 
the evening. Blind piles, with many anal pains. 
Very bad taste i?i the mouth in the morning. Con- 
stant chilliness and evening aggravation. Fainting 
spells. Many pains in the back and abdomen ; she 
cannot lie on her side. Sharp, colicky pain at 



AN OBSTETRIC MENTOR. $$ 

night, followed by a bilious, bloody diarrhoeic stool, 
with much flatus and rumbling in the abdomen. 
" These varieties of nightly diarrhoea are character- 
istic of Pulsatilla." 

Ratanhia: Blind, protruding piles, with consti- 
pation and great sensitiveness of the rectum. 

Sulphur : All kinds of piles, especially painless 
piles, with dark hemorrhages, suppression of the 
hemorrhoidal flux, with headache, vertigo, and 
backache. Weak, faint spells, especially when 
standing or walking, and about ii a. m. Heat on 
top of head. 

Where constipation is present, the excessive ten- 
derness and pains of blind piles may often be re- 
lieved by cold-water injections, a strong lather of 
castile soap being used. Bleeding piles should 
never be treated locally, lest the flow be suppressed. 
If blind piles are highly inflamed, a simple poultice 
is sometimes admissible. In cases accompanied by 
constipation the same rigid regularity of relieving 
the bowels should be observed as was recommended 
under Constipation. The surgical treatment of 
piles during pregnancy is not to be permitted. 

Fissure of the Anus. 

Compare first for — 

Ulceration of Anus and Rectum, Ars., Carbol. ac, 
Ham., Hydrast., Merc, iod., Nat. mur., Paeon., Phos. 

Fissure of Anus and Rectum : i. Ign., Nitr. ac, 
Paeon., Thuja. 2. Caust., Graph., Petrol., Sep., 
Sulph. 

Ulceration of the anus and rectum will usually 
be found associated with piles, and we should con- 
sult indications for that affection. For fissures, the 
following are characteristic symptoms : 



34 AN OBSTETRIC MENTOR. 

Ignatia : Fissure, with haemorrhoids and pro- 
lapsus recti, with pains shooting upward in the rectum 
after stool, particularly a loose stool. Pains return 
at the same hour every day, and are worse from 
walking and standing. Severe proctalgia. Eggert 
regards Ign. an intercurrent rather than a curative 
remedy. 

Nitr. ac. : Sharp, splinter-like pains as if torn 
in the rectum during stool, with smarting and twitch- 
ing continuing for hours after stool. Prolapsus 
recti. Haemorrhages from the rectum. Violent 
proctalgia. Tendency to diarrhoea. She is very irri- 
table and despondent and thinks she will never get 
any better. 

P^eonia : Painful ulcers in the anus and rectum, 
with fissures emanating from the ulcers. The parts 
are swollen and exude foetid moisture. 

Thuja : Fissures, with edges trimmed with, poly- 
poid excrescences or true rectal polypus. Piles. 
Condylomata. Urinary symptoms. Nitr. ac. fol- 
lows Thuja to advantage often. 

Also : 

Causticum : Fissures which tend to dry up and 
have dark brown or purple edges. Walking causes 
pain in and bleeding from the anus. 

Graphites : Fissures in rectum, with many little 
cracks studding the anus. Constipation. 

Petroleum : Fissures, with diarrhoea, herpes, and 
small boils around and at the verge of the amis. 

Sepia : Fissures, with constipation, prolapsus 
recti, and many rectal pains extending into the 
abdomen. Mucous discharge from the rectum. 

Sulphur : Pain in rectum so severe that she can- 
not sit down. Swelling, with smarting, stitching 
pains in the anus which keep her awake all night. 



AN OBSTETRIC MENTOR. 35 

Psoric diathesis. If Sulph. seems indicated and 
fails, study Psorinum. 

Fortunately, ulceration and fissure of the rectum 
is not common during gestation. But where fis- 
sures are found, diarrhoea often accompanies, and 
sometimes one drug is required to cure the diar- 
rhoea, while quite another is necessary to heal the 
fissure. 

Diarrhoea. 

Not infrequently the gastric troubles of preg- 
nancy are accompanied by diarrhoea ; sometimes, 
it alternates with constipation, or it may be, as we 
might say, idiopathic. This last form is by far the 
most dangerous and is more to be dreaded than 
constipation. For if it continues long it may cause 
piles, fissures, and even inflammation of the bowels, 
making miscarriage almost a certainty. And that 
accident may occur, too, simply from the exhaus- 
tion caused by a neglected diarrhoea. When a 
pregnant woman is seized with diarrhoea, whatever 
the cause, she should be put to bed and instructed 
to lie there as quietly as possible. All fruit and 
vegetables, and especially all indigestible food 
should be strictly prohibited and the diet made 
light both in quality and quantity. The abdomen 
should be covered with a flannel apron next to the 
skin. A second apron a trifle heavier should be 
worn at night. If these require washing they 
should be very carefully sun or oven dried and well 
aired before using again. The feet too must be 
kept dry (if they tend to perspire freely, by wiping 
with a flannel) and warm. 

Consult first : 



36 AN OBSTETRIC MENTOR. 

Ant. crud., Cham., Gels., Hyosc, Iris, Lye, Petr., 
Puis., Sulp. 

Ant. crud. : Watery, lumpy, diarrhoea early in 
the morning and at night, with white tongue and 
vomiting and absence of thirst. After acids and 
overheating. 

Cham. : Hot, small, frequent, green and white 
mucous stools of very offensive odor like rotten eggs. 
Very irritable temper. Diarrhoea at night, with 
much colic. After taking cold and getting angry or 
mortified. 

Gels.: Yellow fsecal diarrhoea from sudden de- 
pressing emotions, grief, fright, bad news; occipital 
headache and ache the whole length of the spine. 
Depressed, discouraged state of mind and body ; 
thinks she will have a serious illness. 

Hyosc. : Yellow, watery, painless and involun- 
tary diarrhoea, involuntary jerkings of the muscles, 
involuntary urination, delirium and many nervous 
phenomena. 

Iris vers. : Watery, green or yellow diarrhoea 
with burning at the anus, nausea and vomiting, and 
much gastric disturbance. Diarrhoea comes on 
every morning about two or three o'clock. Aggra- 
vation during hot weather. 

Lycop, : Thin, brown, foetid diarrhoea, with sen- 
sation as of yeast working in the bowels. Very- 
much flatulence, not with stool; dyspeptic suffering 
and fulness in throat and stomach after a meal. 
Red sand in urine, which is very hot ; cutting pain 
in back before micturition. Diarrhoea worse in the 
morning, dyspepsia worse in p. m. and long after 
supper. 

Petrol. : Diarrhoea only in the day time, or in 
the last half of the night and early morning. After 



AN OBSTETRIC MENTOR. 37 

eating cabbage. Puis, is often given unsuccessfully 
when Petr. is the similimum. 

Puls. : Green, bilious, or watery diarrhoea com- 
ing on at night with sharp, colicy pains after eating 
fruits, ice cream or fat food. Much backache and 
chilliness with rumbling of flatulence and weeping 
mood. 

Sulph. : Yellow, brown, green, undigested 
(changeable) diarrhoea, which wakes and urges her 
out of bed early in the morning. No pain, but 
strong urging, or else cutting colic before stool. 
After taking milk ; she cannot eat meat, or bear to 
bathe herself. 

Compare also Aloes, Ars., Bry., Cinch., Coloc, 
Ipec, Merc, Nux v., Phos., Podopb., and Verat. alb. 

Aloes : Yellow, faecal, bloody, jelly-like mucous 
diarrhoea "in gobs," involuntary when expelling 
flatus or urine. Very much flatus with the stool, and 
sharp, cutting colic about the navel. Diarrhoea in 
hot weather coming on very suddenly. Large ten- 
der piles relieved by cold water. Pain and fulness 
in the hepatic region, and sensation of great weight 
in the pelvis. Long gurgling in the abdomen as of 
water running out of a bottle. 

Arsen. : Dark green mucous, or brown, or black- 
ish, watery diarrhoea, with intense thirst and marked 
prostration and restlessness. After eating cold food 
(ice cream, etc.) and drinking ice water. Aggrava- 
tion after eating and drinking and at night. 

Bry. : Diarrhoea coming on when the weather 
suddenly becomes hot. Worse in the morning and 
from every motion. Diarrhoea alternating with 
constipation. Fever, thirst and delirium, threaten- 
ing typhoid. 

Cinch.: Yellow, watery faecal and undigested 



38 AN OBSTETRIC MENTOR. 

diarrhoea after eating fruit, and at night and during 
the prevalence of malarial diseases. Worse in the 
afternoon and every other day. Weakness and pro- 
fuse sweating, especially at night. Pinching, tor" 
menting, {but not une?idurable) colic every afternoon. 

Coloc. : Bright yellow, frothy, watery, or mucous, 
ox green, sour or musty diarrhoea, after eating fruit 
and after grief or indignation, with cutting colic, 
(relieved by bending double), which causes nausea, 
and is not always better after stool. 

Ipecac: Bright green mucous, bloody diarrhoea, 
with incessant nausea, flatulent colic and pale face, 
with blue-ringed eyes. 

Merc. v. : Dark green mucous, bloody corrosive 
diarrhoea in hot weather after getting chilled at 
night, with excessive urging and tenesmus and con- 
stant chilliness. Thirst, aphthous condition of the 
mouth, anus a?id rectum and female genitals, sour night 
sweats on head. 

Nux v. : Thin, brown mucous, or watery diar- 
rhoea of small, frequent stools after use of stimulants, 
high living and cathartic medicines. Alternate con- 
stipation and diarrhoea. Backache as if broken. 
Constant urging and pressure upon the bladder and 
rectum, which is mostly fruitless. Over-sensitive- 
ness to light, noise, strong smells, fear, etc. 

Phos. : White, watery, undigested diarrhoea, con- 
taining little grains like tallow. Worse in the morn- 
ing, and from eating warm food (hot bread, biscuit.) 
Thirst for cold drinks ; vomiting of what has been 
drunk as soon as it becomes warm in the stomach ; 
slender red-haired women. 

Podoph. : Watery, greenish or yellow faecal di- 
arrhoea, with meal-like sediment, and of excessively 
offensive odor. The stools are profuse, usually pain- 



AN OBSTETRIC MENTOR. 39 

less, frequent and gushing, and occur in the latter 
part of the night or early morning, especially in hot 
weather. 

Verat. album : Profuse, black or greenish 
watery stools, with severe pinching colic before 
and during the evacuation and complete prostration 
after it. Cold sweat on the forehead especially — 
sometimes all over. Vomiting during the stool. 
Bell says : "It is useless to give Verat. in painless 
cases" Dr. T. F. Allen remarks : " Everything 
about Verat. is on a large scale. The vomiting is 
profuse, the stool enormous and the pain and thirst 
excessive. 

Hygienic : The diarrhoea of pregnancy is far 
more to be dreaded than the constipation, which is 
sometimes so troublesome, as if long continued it 
may cause an abortion. Guernsey well enjoins 
three essentials, absolute rest in bed or on a lounge, 
suitable diet, and (in cold weather especially) warm 
feet and abdomen. Let a flannel apron be worn 
day and night, so made as to cover the whole space 
from the ensiform cartilage to the pubes ; the diet 
should be scalded milk taken hot, either alone or 
thickened with wheat or rice flour or arrowroot, 
mutton broth, toast and light plain crackers. Gum 
arabic and slippery elm water are good drinks. In 
cases which tend toward dysentery and thirst is a 
great annoyance, claret and water (without sugar) 
may often be safely used. Not unfrequently the 
fat is not all removed from a meat broth ; let your 
broth cool after it has its full strength, remove the 
cake of fat, then salt lightly, and re-heating, serve 
warm. 

If the diarrhoea has been long continued and the 
anal symptoms are prominent, a fissure may be sus- 



4-0 AN OBSTETRIC MENTOR. 

pected, for which condition remedies are given else- 
where. 

Intestinal Repertory. 

Flatulence Incarcerated : i. Carbo. veg., Cham., 
Coca, Graph., Ign., Kali c, Lye, Nitr. ac, Nux. v., 
Plumb., Puis., Staph., Tart. em. 2. Ant. crud., 
Arm, Asar., Canth., Chin., Coloc, Con., Nat. c, Nat. 
mur., Nux. mos., Phos., Phos. ac, Plat., Rheum., 
Squill., Verat. alb. 

Borborgymus : 1. Caust., Chin., Hell., Lye, 
Nux. v., Phos., Phos. ac, Puis., Sulph. 2. Aloes, 
Agar., Arm, Bry., Canth., Carbo. veg., Cham., 
Ignat., Nat. mur., Plumb., Sarsap., Squill., Sepia, 
Spig., Staph., Tart, em., Verat. alb. 

Flatulent Colic : 1. Carbo. veg., China, Lye, 
Nux. v., Puis., Rhodo., Staph., Verat. alb. 2. Anac, 
Arm, Asaf., Aur., Cham., Con., Graph., Hyosc, 
Ignat Nux. mos., Phos., Plumb., Rheum., Squill., 
Tart. em. 

Constipation : 1. Alumin., Bry., Lye, Nux. v., 
Op., Sepia, Sulph. 2. y£scul., Collinso., Hydrast., 
Kali c, Lach., Nat. mur., Phyt., Plumb, met., Puis. 
3. Bell., Calc. carb., Canth., Carbo. veg., Coca, 
Dula, Graph., Kali a, Kreas., Laura, Meng., Merc. 
s., Nitr. ac, Phos., Plat., Sabad., Sil., Stann., Sulph. 
ac, Verat. alb., Verbas. 

Constipation from inactivity of the bowels : 1. 
Alum., Hep., Kali a, Nat. mur., Nux. v. 2. Anac, 
Arm, Camph., Carbo. veg., China, Coca. Ignat., 
Nat. carb., Nux. mos., Op., Phyt., Petr., Puis., 
Ruta., Staph., Sulph., Thuja, Verat. alb., Zinc. 

Constipation from induration of the stools : 1. 
Bry., Magn. mur., Op., Plumb., Verbas. 2. Amm. 
carb., Aur., Carbo. an., Caust., Chelid., Graph., 



AN OBSTETRIC MENTOR. 41 

Kali carb., Merc, sol., Nux. v., Petr., Ruta, Sep., 
Sil., Sulph., Sulph. ac, Thuja. 

Diarrhoea : i. Ant. crud., Cham., Gels., Hyosc, 
Iris vers., Lye, Petr., Puis., Sulph. 2. Aloes, Ars., 
Bry., Chin., Coloc., Ipec, Merc, sol., Nux. v., Phos., 
Podoph., Verat. alb. 3. Aeon., Aram, mur., Asaf., 
Bor., Calad., Calc. o, Carbo. veg., Digit., Lach., 
Nat. mur., Nitr. ac., Phos. ao, Rheum., Rhus tox., 
Sep.,Silicea. 

Painful Diarrhoea. 1. Cham., Coloc, Merc, 
corros., Rheum., Rhus tox., Verat. alb. 2. Aloes, 
Ars., Bry., Caps., Dulc, Merc, sol., Nux. v., Puis., 
Secale. 3. Aeon., Ant. crud., Ipec, Iris vers., Nitr. 
ac, Petr., Sulphur. 

Painless Diarrhoea : 1. China, Ferrum, Hyosc, 
Phos. ac, Podoph., Strain. 2. Bell., Chelid., Opium, 
Phos., Plat. 3. Ars., Cham., Gels., Lye 

Stools knotty, like sheep's dung : 1. Magn. mur., 
Op., Plumb, and Sulph. 2. Amm. carb., Carb. an., 
Caust, Chelid., Graph., Merc, sol., Nux. v., Sepia, 
Sulph. ac, Thuja. 

Stools Acrid, corrosive : 1. Ars., Chin., Ign., Iris 
vers., Merc, sol., Puis., Sulph. 2. Ant. crud., 
Canth., Cham., Coloc, Dulc, Ferr., Graph., Gum. 
gutt., Kali carb., Lach., Nux. v., Phos., Staph., 
Verat. alb. 

Scools alternating Diarrhoea and Constipation : 
Ant. crud., Bry., Lach., Nux. v. 

Stools Bilious : 1. Cham., Puis. 2. Aloes, Ars-. K 
Chelid., Coloc, Dulc, Ipec, Lept, Merc, sol., 
Podo., Verat. alb., Sulph. 

Stools Black : Ars., Bry., China, Lept., Sulph. 
ac, Verat. alb. 

Stools Bloody : 1. Canth., Caps., Coloc, Ipec, 
Merc corros., Nux. v., Phos., Sulph. 2. Apis., 



42 AN OBSTETRIC MENTOR. 

Arn., Ars., Bapt., Bry., Calc. carb., Carbo. veg., 
China, Dros., Ferr., Led., Lye, Merc, sol., Nitr. ac, 
Puis., Rhus tox., Sabina, Sarsap., Sepia, Sil. 3. 
Aeon., Aloes, Iris vers., Verat. alb. 

Stools Changeable : Sulphur. 

Stools Copious : 1. Podo., Verat. alb. 2. Ant. 
crud., Gum. gutt., Iris, vers., Lept., Secale. 

Stools Chalklike : Calc. carb., Digit., Hep., 
Podo. 

Expulsion Difficult (of loose Stool) : Alum., 
Gels., Sil. 

Expulsion Forcible, Sudden : 1. Croton tig., 
Gum. gutt., Podo., Sulph., Thuja. 2. Aloes, Phos., 
Sepia, Verat. alb. 

Stools Frequent : 1. Ars., Bell., Caps., Carbo. 
veg., Cham., Merc, corros., Merc, sol., Nux. v., 
Podo. 2. Aeon., Apis., Bapt, Bry., Canth., China, 
Coloc, Dulc, Gum. gutt., Hyosc., Ipec, Iris vers., 
Sec, Sep., Verat. alb. 

Stools Knotty : 1. China, Coloc, Sulph. 2. 
Calc. carb., Magn. mur., Merc, sol., Op., Rhus tox. 

Stools Green : 1. Cham., Phos., Puis., Rheum., 
Sulph. 2. Aloes, China, Dulc, Iris vers., Merc, 
sol., Phos. ac, Stann., Verat. alb. 

Stools Involuntary : 1. Bell., Carbo. veg., 
Hyosc, Phos., Phos. ac, Secale, Verat. alb. 2. Ars., 
Calc. carb., Chin., Digit., Ferr., Mur. ac, Nat. mur., 
Op., Rhus tox., Sulph. 

Stools Involuntary, during sleep : Arn., Bry., 
Con., Hyosc, Puis., Rhus tox. 

Stool Involuntary, while urinating : Aloes, 
Mur. ac. 

Stool Involuntary, while passing flatus : Aloes, 
Kali carb., Oleand., Phos. ac, Verat. alb. 

Stool Involuntary, with every motion :. Apis. 



AN OBSTETRIC MENTOR. 43 

Stools Mucous : i. Asar., Bor., Caps., Cham., 
Nux. v., Phos., Puis., Sulph. 2. Arn., Ars., Carbo. 
veg., Chelid., China, Coloc, Digit, Graph., Hyosc., 
Ipec, Iris vers., Kali carb., Lept., Magn. mur., 
Merc, sol., Nat. carb., Nitr. ac, Petr., Rheum., 
Rhus tox., Sepia, Sil. 

Stools Purulent : Merc, sol., Sil. 2. Arn,, Ars., 
Canth., Iod., Lye, Puis., Sulph. 

Stools shooting, or pouring out suddenly : 
Croton tig., Gum gutt, Podoph., Thuja. 

Stool Small, Scanty : 1. Ars., Bell., Merc, 
corros. and sol., Nux. v. 2. Aeon., Aloes, Arn., 
Asar., Canth., Caps., Cham., Coloc, Dulc, Oleand. 

Stool-smell like brown paper burning : Coloc. 

Stool-smell cadaverous : Carbo. veg., Sil., 
Strain. 

Stool-smell like rotten cheese : Bryonia. 

Stool-smell like rotten eggs : Cham., Psor. 

Stool-smell foetid : 1. Arg. nit., Sulph. 2. Bell., 
Calc. carb., Cocc, Iod., Lept., Lye, Nitr. ac, Rhus 
tox., Sepia. 

Stool-smell musty : Coloc. 

Stool-smell offensive : 1. Ars., Graph., Op., 
Podo., Psor., Squills. 2. Apis., Gum. gutt., Lach., 
Nux. v., Puis., Sulph. ac. 

Stool-smell putrid : 1. Ars., Asaf., Carbo. veg., 
Coloc, Puis., Sil., Stram., Sulph. 2. Arn., Aur., 
Calc carb., Cham., China, Dulc, Graph., Ipec, 
Nitr. ac, Nux. mos. and v., Oleand., Plumb., Podo., 
Sep., Squill. 

Stool-smell sour : 1. Coloc, Hep., Rheum., 
Sulph. 2. Amm. carb., Bell., Calc. carb., Cham., 
Dulc, Graph., Magn. carb., Merc, sol., Nat. carb., 
Phos., Robina, Sepia. 

Stool without smell (odorless) : Hyosc, Rhus tox. 



44 AN OBSTETRIC MENTOR. 

Stools Undigested : i. Ars., China, Ferr., Graph., 
Hep., Oleand., Phos., Phos. ac. 2. Aloes., Ant. 
crud., Arn., Bry., Coloc, Con., Iris vers., Lach., 
Meny., Nitr. ac, Nux. mos , Pod., Sulph. ac, Sulph. 

Stools Tenacious : Asar., Caust., Merc, sol., 
Plat., Plumb., Sarsap. 

Stools Insufficient : 1. Arn., Cham., Magn. 
mur., Nat. carb., Nux. v., Sulph. 2. Alum., Colch,, 
Hyosc, Sabad., Sepia, Staph. 

Stools (constipated) too large : 1. Bry., Kali 
carb. 2, Graph., Ignat., Lach., Plumb., Verat. alb. 

Stools (constipated) too small : Caust., Merc 
sol., Phos., Sep., Sulph. 

Stools with Ascarides : 1. Calc carb,, China, 
Cina, Ferr., Ign., Sulph. 2. Asar., Merc, sol., Nux. 
v., Phos., Plat., Squill., Sil., Spig., Spong., Teucri. 

Stools with Lumbrici : 1. Cina, Sabad., Sil., 
Spig., Sulph. 2. Aeon., Anac, Calc. carb., Cham., 
Cic, Graph., Nat. mur., Ruta, Secale. 

Stools with Taenia:' 1. Calc. carb., Graph., Plat., 
Puis., Sabad., Sil., Sulph. 2. Carbo. veg., China, 
Kali carb., Nux. v., Petr., Phos., Sepia. 



CHAPTER II. 

Thoracic, Cystic, Renal, Uterine, and Skin 

Diseases. 

Severe pulmonary affections rarely complicate 
pregnancy, and where they do arise the indications 
for remedies are not especially distinctive or differ- 
ent from those at other times appropriate. 

Pulmonary Congestion. 

Aeon., Bell., Cactus, Cimicif., Gels., Phos., San- 
guin., Verat. vir. 

Aconitum: Is the great homoeopathic anti-con- 
gestive and anti-phlogistic. Palpitation of the heart, 
with short, dry cough, violent pressure, dyspnoea 
and great anguish, disturbing sleep, high fever and 
thirst. 

Bell. : Hard beating of the heart, which is felt 
in the head and makes it ache. Short, dry, hack- 
ing cough. Red face, thirst, fever and oppressed 
respiration. 

Cactus: Constriction of the chest and throat. 
She can hardly speak and her voice is hoarse and 
low. Dyspnoea and cardiac palpitation She can- 
not lie down and all symptoms are worse at night 
and when walking or lying on the left. 

Cimicif.: Stitching, lancinating and aching pains 
in the left chest, increased by taking an inspiration. 
Heart beats too fast and strong and very irregularly. 



^6 AN OBSTETRIC MENTOR. 

Gels.: Constricted sensation in the lower part of 
chest. Stitches in lungs from above downwards, 
Dyspnoea, inspiration long, sighing, croupy ; expi- 
ration sudden and forcible. Dark red face and dull 
headache, with heavy countenance. She appears 
as if drunk. 

Phos. : Oppression, heaviness, tension and fulness 
in the chest. Dry, hacking cough. 

Sanguin.: Full, pressing, sore sensation in chest 
with intense burning ache. Dyspnoea, cardiac pal- 
pitation, weakness and marked fever of a low grade. 
Sang, is often the remedy after Aeon, or Verat. v. 

Verat. vir. : Oppression of the chest as of a 
load upon it, with constant nausea, chilliness, and 
constant intense burning ache in the chest. Dry, rack- 
ing cough with high fever. Nervous twitchings of the 
muscles (especially of the face). Verat. vir. com- 
bines handsomely many symptoms of Aeon, and Bell. 
and is often to be preferred to either. 

Dyspnoea (in general): Ars., China, Ipec, Kali c, 
Lach., Lobel. inflat., Mosch., Nux. v., Phos., Puis., 
Samb. 

Ars.: Great weakness, fever, thirst and restless- 
ness. Face swollen and pale, yellow or greenish. 
Feet and legs dropsical, with dyspnoea. She is 
worse after midnight. 

China: Shortness of breath, with flatulent dis- 
tension of the abdomen and periodical colic. 

Ipecac. : Wheezing respiration with nausea, vomit- 
ing and faintness. Face pale or blistered. 

Kali c. : Dyspnoea in phthisical women who awake 
at 3 a. m. and are much worse. Stitching pains 
in the chest and many heart symptoms. 

Lach. : Extreme dyspnoea, worse after sleeping. 
(She cannot lie down again.) Cannot bear any 



AN OBSTETRIC MENTOR. 47 

clothing to touch the throat or waist. Left side 
troubles and history of ovarian or heart affections. 
Constipation. 

Lobelia inflat.: Asthmatic subjects with many 
stomach symptoms and sensation of a lump in 
throat and chest. 

Moschas.: Hysterical sleepless women who faint 
easily and often. Hypochondria. 

Nux. v.; The prime remedy for the dyspnoea of 
pregnant women. Red face, headache, backache. 
She urinates often with great urging. 

Phos.: Phthisical women. —Tall slender red-haired 
women with chronic cough. She is worse before 
midnight. 

Puls. : Difficult digestion; bitter taste after eat- 
ing and in . the early morning. Much chilliness 
even in warm weather or by a fire, and yet she 
wants all doors and windows open and to be fanned 
so that she can breathe. 

Sambuc: Dyspnoea worse before midnight, with 
restlessness and no thirst, eyes half open and de- 
lirium. Dropsical swelling of the feet and hands 
which are bluish as if bruised. Ars. is often used 
when Samb. would do better. 

Cough. 

A cough which arises from disease of the lungs, 
bronchi or larynx, or some other plainly specific 
cause during pregnancy will of course be met by 
the treatment suitable to such affections at other 
times. But there is a sympathetic cough peculiar 
to pregnancy which often harasses the patient and 
annoys her physician by its persistency; and un- 
less checked by remedies it will prove a torment 
to the end of gestation. 



48 AN OBSTETRIC MENTOR. 

Compare first Aeon., Bell., Hyosc, Phos. 

Aconitum: Sore throat, fever, thirst and dry- 
cough, from tickling in the throat. 

Belladonna: Dry, hacking cough, coming on 
every evening or at night with sore throat and 
throbbing headache. 

Hyoscyamus: Dry nervous cough coming on 
when she lies down and keeping her awake all night. 
The cough is not severe, but incessant. 

Phosphorus: Hard dry cough with pains, 
soreness and oppression of the chest and scanty 
white frothy sputa. Hoarseness and rough soreness 
of the throat. 

Study also Caust., Con., Dulc, Ipec, Nat. mur., 
Puis., Sep., Sticta. 

Causticum: Dry hollow cough with scanty sputa, 
great soreness of throat and chest and hoarseness 
or even aphonia. The urine spirts out when cough- 
ing. 

Conium: Dry hacking cough after lying down 
at night and little or no cough during the day. 
When . Hyosc. seems indicated for a dry night 
cough and fails, try Con. in a high potency. 

Dulcamara : Loose spasmodic catarrhal cough 
with profuse mucous expectoration caused by ex- 
posure to cold or damp weather. 

Ipecacuanha : Loose suffocative cough with 
much dyspnoea and violent coughing spells, which 
cause vomiting and strangulation. The chest seems 
full of mucus and but little is expectorated. Colic 
and diarrhoea. 

Natrum mur. : Hard cough with stitches in the 
liver, spirting out of the urine and violent morning 
headache. 

Pulsatilla : Hard cough which shakes her 



AN OBSTETRIC MENTOR. 49 

and makes her feel as if she would vomit, and 
causes uterine pains. Dry cough at night, going off 
when sitting up in bed ; loose cough during the 
day with yellow, greenish, bitter sputa. Diarrhoea 
at night. 

Sepia : Dry cough at night in bed before mid- 
night, or worse morning and evening. Scanty yel- 
low, green, or gray salty sputa. Derangements of 
the portal circulation. Constipation, yellow spots 
(liver matter) on the face. Sepia often follows 
Aeon, well : and both Phos. and Puis, should be 
compared with it. 

Sticta pulmo. : Dry hacking cough (incessant 
at night) with much dryness and soreness of the 
respiratory tract, and oppression and fullness in 
the lungs. I)?y cough after fluent coryza. Sticta 
resembles Phos. and is sometimes to be preferred. 

Cardiac Palpitation. 

This annoying condition is met with during 
pregnancy, mostly in very nervous women, and 
principally at three distinct periods : first, shortly 
after conception, when it is frequently associated 
with plethora ; second, during the fifth month 
when sometimes she can't tell whether she feels 
life or not, and thirdly, during the last month. 

Compare — Aeon., Actea rac, Cact, Ign., Kalm., 
Lach., Mosc, Nat. mur., Phos., Puis., Spig., Verat. 
virid. 

Aconitum : Palpitation with great anguish, fear 
of death, fever and thirst. 

Actea rac: Palpitation of the heart in rheu- 
matic women, or those subject to congestive dys- 
menorrhcea, great melancholy and apprehension 
and sleeplessness. 



50 AN OBSTETRIC MENTOR. 

Cactus : Palpitation of the heart, worse at 
night, when lying on the left side and when walking. 
Constricted sensation in various parts. Severe right 
sided periodical headache. 

Ignatia : Palpitation or stitches in the heart at 
night. Many hysterical symptoms. 

Kalmia lat. : Palpitation of the heart with 
albuminuria, and violent neuralgic or rheumatic 
symptoms. 

Lachesis : Palpitation of the heart with inter- 
mittent pulse, dyspnoea and stitches in the left side. 
She can't bear any pressure on the chest or throat, 
and must sit up or lie on the right side. Always 
worse after sleeping. 

Moschas : Palpitation of the heart with many 
hysterical phenomena, dyspnoea. She talks only 
of approaching death. 

Natrum mur.: Violent palpitation of the heart 
(which shakes the body) from every exertion, worse 
when lying on the left side. Morning headache. 
Chlorotic women. 

Phosphorus : Palpitation of the heart from 
mental emotions with dyspnoea and tightness across 
the chest. Tall slender phthisical women who have 
a revolving morning vertigo, which walking about 
before breakfast. 

Pulsatilla : Palpitation of the heart in violent 
paroxysms with anguish and loss of sight. Con- 
stant chilliness. 

Spigelia : Violent visible and audible palpita- 
tion of the heart. She must lie with her head and 
shoulders well elevated, but is worse by bending 
forward. 

Veratrum viride : Palpitation of the heart 
with dyspnoea, high fever, and delirium, chilli- 



AN OBSTETRIC MENTOR. 5 1 

ness, nausea and burning ache in the cardiac 
region. 

Dysuria. 

Increased frequency of micturition with some 
straining and burning sensations, we have observed 
as early and constant symptoms of pregnancy in 
primiparae especially, but in multiparas as well. 
Whether, these urinary disorders appear in early or 
late stages of gestation, they are alike amenable to 
the homoeopathic remedy, albeit the causes are so 
widely divergent. 

Study. — Aeon., Bell., Cann. sat., Canth., Cupr. 
ars., Equiset., Hell., Lye, Merc, corr., Nux vom., 
Puis., Terebinth., Uva ursi. 

Aconitum : Frequent and violent urging to 
urinate, with scanty emissions of red turbid urine. 
Fever, hot dry skin, thirst, restlessness and anxiety, 
after exposure to cold dry air. 

Belladonna : Micturition in drops of blood- 
red or golden yellow urine, with urging and pains m 
the bladder. Soreness of the bladder, the least 
touch or jar is intolerable. Backache as if it would 
break. 

Cannabis sat. : Urging and pressing to urin- 
ate with some burning during and very much after 
micturition. When Canth. seems indicated and 
fails, Cann. sat. should be tried. 

Cantharis : Very frequent urination with vio- 
lent cutting pain and frightful scalding, burning and 
extreme tenesmus. Bloody or mucous urine 
passed in drops. 

Cuprum ars. : Dysuria with rectal tenesmus 
and the evacuation of mucus. 

Equisetum : Dysuria with albuminous urine. 
Severe pain after urination. 



52 AN- OBSTETRIC MENTOR. 

Helleborus : Dysuria with dark urine and cof- 
fee-colored sediment. Impending dropsy. 

Lycopodium : Violent pain in the back before 
micturition, better after. Urine is hot and clear, 
and contains red gravel. Burning, itching, and 
sharp shooting cutting pains in the bladder, urethra, 
and anus during and after micturition. Flatulent 
dyspepsia and constipation. Lye. resembles Nux 
vom. with some striking distinctions. 

Mercurius cor. : Extreme vesical irritation 
and tenesmus, with bloody albuminous or brown 
urine, brick dust sediment, severe right sided facial 
neuralgia. One of our best remedies for retinitis 
albuminurica. 

Nux v. : Very painful and ineffectual efforts 
to urinate and defalcate. Reddish urine with brick 
dust sediment, sore, burning, and lancinating pains 
in the neck of the bladder during micturition. Next 
to Canthar., Nux is the best drug we have for the 
dysuria of pregnancy, and qur third choice, pro 
re nata, would be Puis. 

Pulsatilla : Continued pressure on the blad- 
der without desire to urinate. Dysuria with drawing 
in the abdomen. Spasmodic pains in the neck of 
the bladder extending to the pelvis and thighs 
after micturition. Scanty brown urine with brick 
dust, bloody or mucous deposit. 

Terebinthina : Dragging, cutting, and burn- 
ing pain in the bladder with dysuria and scanty, 
red or bloody urine, which has the odor of violets, 
and a mucous or thick muddy sediment. 

Uva ursi: Painful micturition with burning 
pains while urinating and slimy, purulent urine-. 



AN OBSTETRIC MENTOR. 53 



Enuresis. 



Incontinence of urine, like dysuria, may appear 
in early or late months of gestation. When at the 
later time it is caused chiefly by pressure of the 
gravid uterus upon the bladder and we shall be 
powerless to give that relief which we may confi- 
dently assume to extend during the earlier stages. 

Consult: Arg. nitr., Bell., Camph., Caust., Equi- 
set., Kreas., Nat. mur., Plantago, Puis., Sepia. 

Argentum nitr.: Profuse, pale urine passed 
frequently at night. 

Belladonna: Enuresis nocturna, with starting 
up, screaming and restlessness during sleep. Re- 
laxation of the neck of the bladder, she cannot re- 
tain the urine, which is copious, yellow and turbid 
and frequently voided. 

Camphora: Paralysis of the bladder and invol- 
untary micturition. After the abuse of diuretic drugs 
such as Cantharides, Turpentine, Copaiba, etc. 

Causticum: Enuresis, when coughing, walking, 
sneezing, and at night. Paralysis of the bladder 
from prolonged (voluntary) retention of urine. 
Dark-haired women, with warts on the hands or 
face, (or both), who are subject to bronchial ca- 
tarrh, with morning hoarseness and even aphonia. 

Equisetum: Enuresis day or night in women 
who had the habit as children. 

Kreasotum: Enuresis at night; wakes from 
deep sleep, with great urging and cannot retain the 
urine, worse when lying down, better while walking 
or standing, profuse bland leucorrhcea. 

Natrum mur.: Enuresis, while walking, stand- 
ing, coughing or laughing, violent desire to urinate 
day and night, which she cannot control. 



54 AN OBSTETRIC MENTOR. 

Plantago: Profuse nocturnal enuresis, caused 
by relaxation of the sphincter vesicae; odontalgia. 

Pulsatilla: The drug to be first thought of 
for the enuresis of pregnant women, involuntary- 
urination in dropsy, while sitting or walking, great 
urgency of the call, she cannot delay at all, worse on 
taking cold, when there is a tough, slimy sediment 
in the urine. 

Sepia: Enuresis nocturna during first sleep, she 
is very nervous about the matter, has a sensation of 
urine passing and gets up thinking she has wet the 
bed, when such is not the case, urine has a strong 
odor and deposits a reddish-pink sediment, which 
adheres tenaciously to the vessel, violent itching of 
the vulva, constipation. 

Ischuria — Anuria. 

Fortunately neither suppression nor retention of 
urine are common during pregnancy. Great care 
should be exercised in such cases however to make 
a correct diagnosis, and unless remedies act prompt- 
ly retention should be speedily met by the use 
of the catheter. 

For Retention of Urine : 

Aeon., Apis, Apoc. cann., Ars., Bell, Camph., 
Canth., Eupat. purp., Nitr. ac, Nux v., Puis. 

For Sicppression of Urine: 

Apoc. cann., Camph., Eupat. purp., Helleb., Stram. 

Aconitum: Retention, with stitches in the 
region of the kidneys, fever, thirst, restlessness and 
anxiety, worse from exposure to cold, dry air. 

Apis: Retention or suppression of urine, inces- 
sant desire to urinate but inability to pass more than 
a few drops of high-colored urine or none at all. 
Holcombe says: " The dose of Apis must vary with 



AN OBSTETRIC MENTOR. 



55 



the state of the renal secretion; if the flow is 
excessive, the high dilutions are best; if it is very- 
scanty or suppressed the lowest succeed." 

Apoc. cann.: Urine retained, scanty or sup- 
pressed, skin dry and hot, constipation, dropsy, 
general or local uterine haemorrhage. 

Arsen.: Retention of urine, from paralysis of the 
bladder. Burning in the urethra at the commence- 
ment of micturition, ceasing upon the full estab- 
lishment of the stream; restlessness, cold sweat and 
the characteristic thirst. 

Bellad. : Retention of urine, with congestive 
headache and backache, urine clear at first; becomes 
turbid on standing, hypogastrium very sensitive to 
the lightest touch or jar even, and suffers stitching 
pains toward the perineum. 

Camph.: Retention of urine, with constant de- 
sire to urinate. After the abuse of diuretics. 

Canth.: Retention of urine, with pain in the 
back and incessant efforts and agonizing urging to 
urinate, cutting pains through and in the bladder, 
the urine dribbles away with cutting and burning 
in the urethra. 

Eupat. purp.: Retention or even suppression 
of urine, vertigo, with tendency to fall to the left, 
threatened abortion at the third or fourth month, 
cutting, aching pains in the kidneys and bladder, 
with urging to urinate. 

Helleb. niger.: Suppression of urine, which is 
very dark with a sediment like coffee-grounds, bad 
cases where the irritation at the neck of the bladder 
threatens to run into inflammation. 

Nitr. ac: Painless retention of urine, the urine 
is cold when emitted, and very foetid (like that of 
horses), nightly desire to urinate, with burning in the 



56 AN OBSTETRIC MENTOR. 

urethra and cutting in the abdomen, she urinates in 
hopes to relieve these symptoms, but they are worse 
after the act. 

Nux v.: Spasmodic retention of urine, with 
urging and frequent ineffectual efforts to urinate, 
burning, lacerating, sore pains in the neck of the 
bladder during micturition, constipation, head- ache 
and backache, very irritable disposition. 

Pulsat.: Retention of urine, with redness, heat 
and soreness of the vesical region externally, 
pressure on the bladder without desire to urinate, 
desire to urinate with drawing pain in the abdomen, 
frequent ineffectual urging, with cutting pains, spas- 
modic pains in the neck of the bladder, extending 
to the thighs, after urinating. 

Stram. : Retention and suppression of urine ; 
it dribbles away slowly, and painlessly. Illusions 
of the senses : she fancies she sees rats and mice, 
snakes, etc., and is constantly looking under the 
bed for them. 

Albuminuria and Uraemia. 

Although albumen is almost universally found in 
the urine of pregnant women at some stage or 
other of gestation, yet its presence in any consider- 
able quantity, must always be viewed with appre- 
hension; and prompt and persistent treatment should 
be employed to meet any untoward symptoms and 
avert the more alarming complications of uraemia, 
retinitis albuminurica, and puerperal convulsions. 

Compare: * Apis, *Apoc. cann., Kalm., * Merc, 
corros., and * Terebinth. 

Kalmia : Albuminuria with nausea and eructa- 
tions of wind, worse about eight or nine o'clock 

* See Dysuria, Enuresis, and Ischuria. 



AN OBSTETRIC MENTOR. 57 

a. m. Stiff drawing sensation in the eyes on mov- 
ing them. Shifting rheumatic pains in the arms, 
especially the right arm. Painful stiffness and 
aching in the back. Prosopalgia very severe and 
worse on the right side ; neuralgic pains in the 
bowels. 

Retinitis Albuminurica. 

It seems to us almost a mistake to call nephritic 
retinitis a disease ; for the condition of the retina 
is a symptom and sometimes a diagnostic symptom 
of the grave renal trouble which occasioned the 
ophthalmic lesions. Whenever a pregnant woman 
begins to complain of any diminution of seeing 
power, the urine should at once be tested for albu- 
men and the eye examined by an expert ophthal- 
moscopist. Or the presence of albumen in the 
urine alone should lead us to watch the eyes and be 
ready to fight the nephritis from the incipiency, feel- 
ing assured that only so can we have any measure 
of success. 

Consult: i. *Apis, *Ars., Gels.,* Kalm.,* Merc. 
corros., Zinc. 2. *Colch., Kali acet., *Phos. 

Retinal Hemorrhages : Arm, *Bell., Crot., 
*Lach., *Phos. 

Apis. : CEdema of the lids and general dropsy, 
very drowsy, little thirst and pale and scanty 
urine. 

Arn. : Retinal haemorrhage, particularly that 
of traumatic origin. 

Ars. : Restless all the time but especially at 
night before midnight. Great thirst for small quan- 
tities of cold water frequently. Urine scanty and 
albuminurious. 

* Compare also Dropsy and Albuminuria. 



■■ 



58 AN OBSTETRIC MENTOR. 

Bell. : Retinal hemorrhage from congestive 
headache. Retina and optic nerve congested and 
inflamed. 

Crotal. : Retinal haemorrhage when Lack, seems 
indicated and does not benefit. 

Gels. : Retinitis albuminurica during preg- 
nancy especially. Extravasations of blood and 
white patches in the retina. Sudden dimness of 
vision. Serous infiltration into the vitreous, mak- 
ing it hazy. Thirstlessness, evening fever and albu- 
minous urine. 

Kali acet. : Amauroses coming on suddenly in 
both eyes during acute nephritis. 

Lach. : Retinitis with haemorrhage, " very com- 
monly called for when no characteristic symptoms 
are present except the pathological changes. The 
retina and optic nerve are inflamed and congested, 
while throughout the retina may be observed extra- 
vasations of blood of various ages and sizes." Allen 
and Norton. 

*Zinc : Periodic and temporary amaurosis during 
severe attacks of headache. 

Dropsy. 

CEdema of the lower extremities and vulva is 
very common during pregnancy. Usually it occurs 
only during the later months and is not so extreme 
as to cause very great inconvenience. Should 
ascites come on, or the local dropsy become very 
great we should feel more concern. And if albumin- 
uria and symptoms of amaurosis and uraemia still 
further complicate the case, we shall be on our 
guard against the gravest of conditions. 

Not infrequently a discharge of water from the 
vagina takes place from time to time with these 



AN OBSTETRIC MENTOR. 59 

dropsies, which is very perplexing to the inexperi- 
enced. This is a symptom of the general dropsical 
condition, and other things being equal is not a 
dangerous symptom. It is styled hydrorrhcea or 
false waters* An acute dropsy, dropsy of the 
amnion is of course peculiar to pregnancy, but not 
of great frequency. This disease causes great suf- 
fering, runs a rapid course, and is not often recog- 
nized until so fully developed that abortion is a 
certainty. Women who have once suffered it 
should be subjected to prophylactic treatment dur- 
ing subsequent pregnancies and carefully watched. 

Dropsy (in general.) : i. Apis., Apoc. 
cann., Ars., Colch., Digit., Dulc, Hell., Helon., 
Lye, Merc, corr., Uran. nitr. 2. Aur., Bell., Benz. 
ac, Bry., Cact., Canth., China, Convolv., Ferr., 
Kalm., Kali c, Lact., Led., Merc, sol., Phos., 
Phyt., Rhus tox., Senec, Sep., Sulph., Terebinth. 

CEdema of the Feet. 

Ars., Chin , Ferr., Kali c, Lye, Merc, sol., 
Phos., Puis., Rhus tox., Sulph. 

Apis : "Absence of thirst is very characte?'istic of 
Apis in uterine dropsy" says Guernsey. Stinging 
pains as of bee stings. Abdomen very tender to 
touch. Urine profuse and pale (high dilution) or 
scanty and high-colored (low dilution.) (Edema 
of the face, hands, legs, ankles, feet and labia. 

Apoc. cann.: Ascites : sinking in and irrita- 
bility of the stomach, even water is speedily re- 
jected. Great thirst, muddy urine, diarrhoea. Face 
bloated while lying down, passing off when sitting up. 
" Whenever it acts beneficially, the skin becomes 

* See Guernsey's Obstetrics, p. 357. 



60 AN OBSTETRIC MENTOR. 

moist before the urine becomes more abundant." 
Lilienthal. (Edema of the feet and ankles. 

Ars. : GEdemaof the lower extremities. The face 
appears pale, earthy, waxy or greenish. Great pros- 
tration and thirst j drinks frequently and very little. 
Suffocative spells at night while lying on her back. 
Great anxiety and dyspnoea, must jump out of bed. 

Aur. : Albuminuria and dropsy with suicidal 
melancholy. 

Bell. : Urine dark and scanty or golden yellow. 
Worse after three p. m. Tenderness of the abdomen 
aggravated by the least jar of the bed or chair which 
she occupies. She even steps with great care while 
walking to avoid any jar. 

Benz. ac. : Urine high-colored, hot, scalding, and 
of strong, pungent ammoniacal odor. She wakes every 
morning at two o'clock with humming in the ears 
and beating in the temporal arteries which prevents 
her from going to sleep. 

Br yon. : The swelling increases during the day and 
diminishes during the night. Urine dark and scanty, 
and deposits a pinkish stain. GEdema of the lower 
eyelids and feet. Constipation. Splitting head- 
ache. Great thirst for cold water. 

Cact.: CEdema of the hands (especially left). 
GEdema of feet and legs to the knees. Skin shining. 
Pressure with the finger leaves a dent a long time. 
Copious straw-colored urine, passed by drops with 
burning. 

Canth. : Pain in the abdomen, vomiting and 
fever. Bloody urine and strangury, tenesmus of the 
cervix vesicce. Albuminous urine containing cylin- 
drical casts. Pains in the limbs and chronic coryza. 

China : Dropsy from haemorrhages or loss of 
other vital fluids. Abdomen distended. She belches 



AN OBSTETRIC MENTOR. 6 1 

wind frequently without relief. Urine dark, scanty 
and sandy. 

Colch. : (Edema of the pale face and of the cold 
hands, feet and legs. Urine dark, scanty, and 
discharged in drops depositing a whitish sedi- 
ment. 

Convolv. : Urine almost entirely suppressed. 
Constipation with abdominal disturbance. But good 
appetite. 

Digit.: Dropsy with difficult urination. Stools 
light color. The heart sympathizes : pulse quick, 
fine and intermittent. Cyanosis. 

Dulc. : Dropsy after suppressed sweat from cold, 
damp air. 

Ferr. : Dropsy with cold skin, constant chilli- 
ness and evening fever. Very weak and nervous 
but face fiery red. 

Hell. : Urine almost suppressed, very dark, and 
deposits a sediment like coffee grounds. Slow com- 
prehension. Griping pains in the abdomen, and 
diarrhoea of jelly-like mucus. Debility. Piercing 
pains in the limbs. 

Helon. : Dropsy from albuminuria, general 
debility or haemorrhage. Urine pale yellow. 

Kali carb. : Weakly women with chronic 
bronchitis worse at three a. m. Sacculated swelling 
of the upper eyelid. 

Kalmia : Dropsy with albuminuria. Retinitis. 
Rheumatic pains in the arms and back.. Neuralgia 
facial. 

Lact. : (Edematous swelling of the abdomen, 
feet and eyelids. Asthmatic and heart affections. 

Lach. : Cyanosis. Urine black. Legs ©edema- 
tous, first left, then right. 

Ledum. : Pains in the limbs : skin dry. She feels 



" 



62 AN OBSTETRIC MENTOR. 

very cold and cannot keep warm. Worse from 
warmth. 

Lyc. : Red sand in the uri?ie ; terrible backache 
just before micturition. Borborygmus in left hypo- 
chondrium. Satiety, even after eating a very little. 
One foot cold the other hot. (Edema of the feet. 
Ascites. Restless sleep. Feels worse on getting awake. 
Upper part of the body emaciated, the lower enor- 
mously swollen. When Lyc. seems well indicated 
and fails, consider Rhus tox. 

Merc. corr. : (Edema of the face and labia. 
Albuminuria. Right sided prosopalgia. 

Merc. sol. : Much perspiration affording no re- 
lief. Constant short racking cough. Not much 
thirst. 

Phos. : (Edema of the face, hands and feet. 
Shaking exhaustive cough with dyspnoea. Gray 
sand in the urine, which is turbid and whitish like 
curdled milk ; brick dust sediment. Variegated cuti- 
cle on urine, and albumen in it. Amaurosis. 

Phyt. : Dark red albuminous urine leaving 
a deep stain in the vessel. Aching of the heels. 
Chronic dry sore throat. 

Puls. : Constant chilliness. (Edema of the feet. 
Many uterine symptoms. 

Rhus tox. : Dropsy with turbid urine. (Ede- 
ma of the lower limbs. Restless sleep, she ?nust 
change her position often. Rheumatic stiffness in the 
back, better after moving about a little, which she is 
certain comes from her kidneys. Terrible cough, 
which seems as if it would tear something out of her 
chest. Lycop. is sometimes prescribed when Rhus 
is the similimum. 

Senecio: Abdomen swollen, very tense; lower ex- 
tremities oedematous. Pain in lumbar region. 



AN OBSTETRIC MENTOR. 63 

Urine alternately scanty and high colored, or co- 
pious and pale. 

Sepia: Rises frequently at night to urinate; 
urine turbid and deposits a red mud which adheres 
tenaciously to the vessel; or blood red with a white 
day-like sediment (which it is also difficult to remove) 
a cuticle on its surface; or it is so foetid and offen- 
sive that it must be at once removed from the room. 
CEdema of the labia. Dropsy after miscarriage. 

Sulph.: Dropsy from suppressed eruptions. 
Moaning during sleep, quick pulse, cold feet, sweat- 
ing of the face. Heat in crown of head. Consti- 
pation or morning diarrhoea with painless urging. 
Pimply rough skin. 

Terebinth.: Dropsy with albuminuria. Pressing 
pain in kidney region while sitting down, better 
while moving about. Dysuria; urine bloody, de- 
posits a thick slimy, muddy sediment; urine scanty, 
turbid, dark and deposits an epithelial sediment: 
urine has the odor of violets. 

Uran. nitr. : Albuminuria. Urination increased 
in frequency and preceded by a pain over left eye. 
Ill temper and debility. 

Urinary Repertory. 

Urine Acid.: i. Hep., Merc, s., 2. Arn., Bor., 
Cact., Cann. sat., Caust., Clem., Cocc, Graph., 
Iod., Kali c, Natr. mur., Par., Phos., Rhus tox., 
Senega, Thuja. 

Urine bloody: 1. Canth., Puis., 2. Ars., Calc. c, 
Caps., Cann., Ipec, Lye, Merc, sol., Mez., Nux v., 
Phos., Sars., Sec, Sep., Sulph., Terebinth., Uva ursi, 
Zinc. 

Urine black: 1. Colch., Hell., Nat. mur., Lach. 
2. Erigeron (dark urine turning pale.) 



64 AN OBSTETRIC MENTOR. 

Urine cloudy when voided: 1. Cina., Con., 
Merc, s'., Sabad. 2. Ambra., Ant. crud., Cann. 
sat., Caust, China, Dulc, Ign., Phos., Puis., Rhus 
tox., Sep. 

Urine cloudy, after standing: 1. Bry., Cham., 
Phos. ac. 2. Acetic ac, Caust., Cina, Graph., 
Hep., Merc, s., Mez., Rhus tox., Senega, Sulph., 
Valer. 

Urine dark: 1. Aeon., Bell., Bry., Colch., Merc, s., 
Tart. 2. Verat. alb. 3. Ant., crud., Arn., Calc. c, 
Canth., Carbo v., Dig., Hell., Hep., Ipec, Puis., 
Selen., Staph., Sulph. 

Urine Flaky: 1. Canth., Mez. 2. Cann. sat., 
Cham., Sarsap., Zinc. 

Urine Frothy: Lach., Lye, Seneg., Spong. 

Urine greenish: 1. Camph. 2. Ars., Aur. fob, 
Berb., Bov., Chin., Colch., Iod., Kali carb., Magn. 
carb., Oleum an., Rheum., Ruta, Verat. alb. 

Urine greasy and varigaled pellicles on surface: 
1. Paris. 2. Colch., Hep., Iod., Lye, Petrol., Phos., 
Puis. 

Urine hot and scalding: 1. Ars., Canth., Hep., 
Lye. 2. Aeon., Caps., Cham., Colch., Dig., Merc. 
s., Phos. ac, Squill. 

Urine milky: 1. Aur. mur., Cina, Phos., ac. 2. 
Carbo v., Coloc, Con., Merc, s., Mur. ac, Nitr. ac, 
Phos., Sulph. 

Urine mucous: 1. Nat. mur., Puis. 2. Ant. crud., 
Canth., Coloc, Dulc, Merc, s., Verat. alb. 

Urine odor like ammonia: 1. Asaf. 2. Benz. ac, 
Iod., Mosch., Nitr. ac, Pareira, Petr., Phos. 

Urine odor foetid. 1. Ars., Carbo. veg., Dulc. 2. 
Merc, s , Nitr. ac, Nat. mur., Petr., Phos., Phos. ac, 
Puis., Sep., Stann., Sulph., Viol, trie 

Urine odor filthy: Oleum an. 



AN OBSTETRIC MENTOR. 65 

Urine odor urinous in excess: Benz. ac. 

Urine odor sweet: Lactue, Nux mos., Tere- 
binth. 

Urine pale, colorless: i. Apis, Con., Nitr. ac, Phos, 
ac, Plant., Puis. 2. Agar., Alum., Angust., Apoc. 
cann., Am., Aur. fol., Bell., Colch., Coloc, Dig., 
Eupat. purp., Erig., Ign., Magn. c, Mur. ac, Phyt., 
Polygon., Puis., Phos., Phos. ac, Plat., Rhus tox., 
Rumex, Sang., Senec, Sarsap., Sec, Sep., Staph., 
Stram., Stront. 

Urine purulent. 1. Canth., Clem. 2. Cann. sat., 
Con., Lye, Nitr. ac, Puis., Sabin., Sep., Sil., Sulph. 

Urine sticky or viscous: 1. Coloc. 2. Arg. nitr., 
Canth., Cupr. met., Dulc, Kreas., Phos. ac. 

Sediment bloody: 1. Canth., Hamam., Nux v., 
Phos. ac, Puis., Sep., Sulph. ac. 2. Aeon., Dulc, 
Hell., Lye, Phos., Sulph., Tereb., Uva ursi, Zinc 

Sediment cloudy: Bry., Nitr., Phos., Seneg. 

Sediment clay-like: Anac, Sars., Sep., Sulph., 
Zinc. 

Sediment flaky: Berb., Canth., Merc, Mez., Zinc. 

Sediment like flour: Calc carb., Graph., Merc, 
Nat. mur., Phos. ac, Sulph., Tart. em. 

Sediment mucous: 1. Chimaph., Dulc, Nat. 
mur., Puis., Valer. 2. Ant. crud., Asclep. tub., Aur., 
Berb., Bry., Caust. Coloc, Con., Eriger., Eupat. 
purp., Merc, Nat. carb., Phos. ac, Sarsap., Senec, 
Seneg., Sulph., Sulph. ac. 

Sediment of mucous threads in the urine: Cann. 
sat., Canth., Merc, Mez., Nitr. ac, Seneg., Tart. em. 

Sediment purulent: 1. Canth., Cham., Lye, Puis. 
2. Calc. carb., Cann. sat., Chimaph., Clem., Cann., 
Kali carb., Nitr. ac Nux v., Sep., Sel. 

Sediment Reddish : 1. Canth., Nat. mur., Puis., 
Sep., Valer. 2. Aeon., Ambr., Ant. crud., Arm, 



66 AN OBSTETRIC MENTOR. 

Chin., Dulc, Lach., Lye, Nat. mur., Nitr. ac, Sil., 
Squill. 

Sediment Sandy, Gravelly : i. Ant. crud., Calc. 
carb., Lye, Phos., Ruta, Sarsap., Sil., Zinc. 2. 
Ambr., Arn., Chin., Menyanth., Nat. mur., Nitr. ac, 
Nux mos. and vom., Puis., Thuja. 

Sediment Whitish : 1. Phos., Rhus tox. 2. Co- 
loc, Colch., Con., Eryng., Eupat., perf. and purp., 
Hep., Nitr. ac, Oleand., Petr., Plant., Phos., Phos. 
ac. Phyt., Sep., Spig., Sulph., Valer. 

Sediment Yellow : 1. Cham., Phos., Sil., Spong., 
Sulph. ac, Zinc. 2. Aram, carb., Bar. carb. 
Canth., Cupr., Lach., Lye 

Desire to Urinate Ineffectual : 1. Aeon., Canth., 
Dig., Sarsap. 2. Arn., Ars., Camph., Coloc, 
Hyosc, Kaii carb., Nux v., Phos., Phos. ac, 
Plumb., Puis., Stram., Sulph. 

Discharge Too Copious : 1. Arg. nitr., Mur. ac, 
Rhus tox., Squills, Verbas. 2. Acet. ac, Agn., 
Apis, Bar. carb., Bism., Canth., Guai., Ign., Merc. 
s., Nitr. ac, Phos. ac, Sang.,Seneg., Tarax., Viol, trie 

Discharge Too Scanty: 1. Apis, Apoc. cann., 
Canth., Colch., Digit., Graph., Hell., Op., Ruta, Sulph. 
2. Aeon., Ars., Arum triph., Bell., Bry., Caust., 
Chin., Dulc, Hep., Hyosc, Kali carb., Lach., Lauro., 
Nitr. ac, Nux v., Phos., Plumb., Puis., Sulph., Te- 
reb., Verat. alb. 

Discharge Too Frequent : 1. Agar., Bar. carb., 
Canth., Caust., Merc, Nitr. ac, Rhus tox., Squill., 
Staph. 2. Bry., Coccu. cact., Ferr., Phos., Ign., Kali 
carb., Kreas., Lach., Mur. ac, Natr. carb., Phos. ac, 
Plant., Selen., Spig., Thuja. 

Discharge Too Seldom : 1. Canth. 2. Aeon., Arn., 
Ars., Aur., Camph., Hep., Hyosc, Lauro., Nux v., 
Op., Plumb., Puis., Ruta, Stram. 



AN OBSTETRIC MENTOR. 67 

Discharge By Drops (Dribbling) : i. Canth., 
Sulph. 2. Arn., Canth., Clem., Dulc, Petrol., 
Sulph., Strain., Thuja. 

Discharge Intermittent : i. Clem., Con. 2. 
Agar., Caust., Dulc, Sulph., Zinc. 

Complaints Before Urinating : 1. Bar., Coloc, 
Lye, Nux v., Puis. 2. Arn., Bry., Digit., Phos. 
ac, Rhus tox., Sulph., Tart. em. 

Complaints When Beginning to Urinate : Canth., 
Clem., Merc. 

Complaints While Urinating : 1. Alum., Canth., 
Cann. sat., Hep., Lye, Merc, Phos. ac, Puis., 
Thuja. 2. Acet. ac, Aeon., Clem., Colch., Con., 
Ipec, Nitr. ac, Nux v., Phos. Sarsap., Sep., Sulph. 
Verat. alb. 

Complaints on Cessation of Flow : Bry., Canth., 
Sarsap., Sulph. 

Complaints After Urinating : 1. Canth., Coloc, 
Hep., Merc, Nat. mur., Sarsap., Thuja. 2. Anac, 
Arn., Bell., Calc carb., Cann. sat., Caps., Chin., 
Con., Digit., Nat. carb., Nux v., Par., Puis., Ruta, 
Staph., Sulph., Zinc. 

Specific Gravity Too High : Asclep. syra.,. 
Eupat. purp., Helon., Myr., Phyt., Puis., Senec. 

Specific Gravity Too Low :• Eryng., Eupat. purp. 
Puis. 

Bladder Remedies : 1. Canth., Hyosc, Lye, 
Nux v., Puis., Ruta, Uva ursi. 2. Aeon., Ant. 
crud., Arn., Bell., Calad., Caps , Dulc, Mur. ac, Pe- 
trol., Sarsap, Squill., Sep., Staph. 

Urethra Remedies : 1. Cann. sat., Canth., Caps., 
Clem., Merc, Phos., Thuja. 2. Aeon., Bry., Calc. 
carb., Caust., Chin., Colch., Con., Mez., Nat. mur., 
Nitr. ac, Nux v.. Phos. ac, Puis., Sabin., Sep. 
Sulph., Zinc. 



68 AN OBSTETRIC MENTOR. 

Kidney Remedies : i. Arg. nitr., Apis, Berb., 
Canth., Chimaph., Kalm., Merc, corr., Nux v., Te- 
reb., Uva ursi. 2. Lye., Phos., Sarsap., Uran. nitr. 

Uterine Congestion : The symptoms which were 
formerly laid down under " Plethora" in textbooks 
may be caused by congestions of various parts (e.g. 
the head, lungs, and uterus). A highly congested 
state of the mucous lining of the cervix uteri is not 
uncommon in the early stages of pregnancy, and in 
fact at any stage where there is persistent " morning 
sickness." The local application of Calendula, 
either in a warm aqueous solution or in a glycerole 
has proven very useful in such cases. 

Compare Actea rac, Bell., Cauloph., Gels., Ign., 
Puis., Sep., Sec, Trill., Ustil. 

Uterine Displacements. 

Uterine deviations are not very common during 
pregnancy if we except anteversion during the later 
months. But when found may easily be recognized 
and demand prompt and intelligent attention. If 
drugs do not speedily relieve urgent cases, the use 
of a suitable pessary is advisable, otherwise the most 
serious consequences may follow. 

Prolapsus may usually be helped by putting the 
patient upon her back, keeping her quiet, and ex- 
hibiting the similimum. The growth of the ovum 
will assist the cure and ultimately prevent prolapsus. 

Anteversion may be treated in the same way, un- 
less it is of so extreme a type that the fundus is 
caught below the symphysis pubes. It will then be 
necessary to gently replace the organ and enjoin 
rest. 

Retroversion is the worst form of uterine devia- 
tion observed during pregnancy. It generally comes 



AN OBSTETRIC MENTOR. 69 

on slowly during the third month, and at last reach- 
ing its climax the patient is seized with those vio- 
lent and unmistakeable symptoms which show that 
the fundus is bound down by the sacral promontory. 
The uterus should be replaced, and the patient in- 
structed to lie as much as possible on her face. 
Nor will most accoucheurs be satisfied until a retro- 
version pessary is put under the organ to retain in 
situ, where it will rarely remain without this assist- 
ance after being once extremely retroverted. 

Prolapsus Uteri : Actea, Alectris, Aur., Bell., 
Calc. carb., Cauloph., Con., Helon., Kali carb., 
Lilium, Nat. mur., Nux v., Phos., Podo., Puis., Sep. 

Anteversion of the Uterus : Aur., Bell., Calc. 
carb., Ferr., Helon., Lilium, Merc, Nux v., Plat., 
Sep. 

Retroversion of the Uterus : Actea, tEscuI. hip., 
Bell., Calc. carb. and phos., Cauloph., Ferr., Helon., 
Kali carb., Lilium, Lye, Murex, Nux v., Plat., Sep., 
Sulph. 

Actea ras.: Prolapsus and retroversion. Sen- 
sation of weight and bearing down in the uterine 
region with heaviness and torpor in the lower ex- 
tremities. Neuralgia or rheiunatoid diathesis. His- 
tory of dysmenorrhcea and abortion. 

JEscul. hip. : Pain about the sacro-iliac symphysis. 
She cannot walk because her back gives out. Con- 
stipation and haemorrhoids. 

Alectris: Prolapsus uteri. Obstinate nausea 
and vomiting of pregnancy* False pains. Abortive 
habit. Debility. 

Aur. fol.: Falling and anteversion of the womb. 
Heaviness in the abdomen with icy cold hands and 

* See Morning Sickness. 



70 AN OBSTETRIC MENTOR. 

feet. Suicidal melancholy. Very sensitive to pains 
and cold air. 

Bell.: Useful in all uterine displacements. Pres- 
sure as though everything was coming down through 
the external genitals, especially in the morning. 
Heat and dryness of the vagina. Sharp pains 
come and go suddenly in the pelvis and back, leav- 
ing the latter so sore she can hardly move. . 

Calc. carb.: Like Bell., Calc. is often useful in 
uterine displacements. Feet and legs feel as if she 
had on wet stockings. Vertigo on going up stairs ; 
she is out of breath and must sit down to rest be- 
fore she reaches the top Constant wearing ache in 
the vagina and rectum. Melancholy as it gets dark 
at night. 

Calc. phos. : Especially retroversion. Every 
cold causes rheumatic pains in the joints and other 
parts. 

Cauloph. : Prolapsus and retroversion. Uterine 
congestion, with fulness, heaviness and tension in 
the hypogastrium. Drawing pains in the groins. 
Threatened miscarriage. 

Con.: Induration and prolapsus. Vertigo when 
turning over in bed. hiterinittent urination. Breasts 
sore, enlarged and painful. History of ovarian 
troubles in the individual and of cancer in the family. 

Ferr. : Weak ancemic women with fiery red faces. 
More especially ante- and retroversion. 

Helon. : A very useful drug in womb diseases. 
Deep undefined depression and sensation of sore- 
ness and weight in the uterus ; consciousness of a 
womb. Flooding and threatened abortion after 
lifting the least weight or moving about a little. 
Albuminuria, pruritus pudendi. Helon. much re- 
sembles Conium. 



AN OBSTETRIC MENTOR. 7 1 

Kali carb.: Heavy aching pain in the small of 
the back. Stitching pains in and about the uterus. 
She has a dry bronchial cough and wakes at 3 a. m. 
feeling very badly every way. 

Lilium : All uterine displacements. Bearing 
down as if everything would come through the vagina: 
she must put her hand on the vulva to prevent this. 
Severe neuralgic pains in the uterus. She dates all 
her troubles from a miscarriage. Her pains and 
bearing down seem to extend and drag from the 
shoulders and chest downward. 

Lyc: Especially retroversion. Flatulent dys- 
pepsia and constipation Terrific pain in the back 
previous to micturition, with relief as the very hot 
urine flows j red sand in the urine. Cutting across 
the hypogastrium from right to left. 

Merc, sol.:* "A very valuable remedy for all 
displacements." Cold clammy sweat on the thighs 
every night. Deep sore pain in the pelvis. Ab- 
domen feels weak as if it must be held up. Itching 
of the genitals. 

Murex.: Retroversion especially. Sore pain in 
the womb as if cut by some sharp instrument. 
Nervous temperament, strong will and cheerful dis- 
position. Pain in the right side from the abdomen 
into the chest. Nymphomania. 

Nat. mur. : Prolapsus: Pushing towards the 
genitals every morning : She has to sit down to 
prevent prolapsus. She awakens every morning with 
a violent headache. Itching of external parts and 
falling off of the hair. Constipation and fissure of 
the anus. She imagines there are robbers in the 
house at night, and it must be searched to quiet her. 

* Guernsey. 



72 AN OBSTETRIC MENTOR. 

Nux v : A royal remedy for uterine deviations, 
arising from lifting or straining. Aggravation from 
walking and standing. Dyspepsia, constipation and 
piles. Urinates frequently and but little at a time. 
Headache and backache. She wakes at 3 a. m. and 
can't get to sleep again. A careful choice must 
often be made between Lye. and Nux. v. 

Plat.: Great sensitiveness of the genitals and 
continual pressure and bearing down. The body 
cold and numb. Constipation : the stool is soft 
and sticks to the anus like clay. Melancholy, or 
peculiar proud defiant mood : she feels a little more 
important than other persons and above them. 

Phos. : Tall, slender, red haired phthisical 
women who pass long narrow hard dry stools. 
Stitches upward from the vagina cut the pelvis. 
Heat running up the back. Emptiness and weak- 
ness in the abdomen. 

Podo. : Prolapsus uteri and ani together, espec- 
ially after confinement. Sensation as if the genitals 
would come out during stool. Constipation and 
liver trouble : or morning (and after part of the 
night) diarrhoea. 

Puls.: She cries at everything and is very de- 
spondent, very bad taste in the morning. Pressure 
in the abdomen and small of the back as from a 
stone, with disposition of the lower limbs to go to 
sleep when sitting, with ineffectual desire for stool. 

Sepia : Retroversion especially. Pressing in 
the uterus, oppressive breathing : Sensation as if 
everything would come out of the vagina : she has 
to cross her legs to prevent it. Constipation with 
sensation of weight in the anus not relieved by evacu- 
ation. 

Sulph.: Burning in the vagina and of the soles 



AN OBSTETRIC MENTOR. 73 

of the feet. She stoops in walking because so weak ; 
worse between n and 12 ; she wants her dinner 
early. Heat in the crown of the head. 

Leucorrhosa. 

.This affection is not common during pregnancy, 
save in women who are predisposed to it. And the 
indications for the use of remedies will not vary 
greatly from those depended upon at other times. 
We may, however, first and particularly con- 
sult : 

Cham., Cocc, Collinso., Kreas., Puis., Sep., Sabin* 

Cham.: Yellowish smarting leucorrhoea, particu- 
larly after a meal. Nervous irritability and hysteri- 
cal spasms. 

Cocc: Leucorrhcea like serum mixed with a 
purulent ichorous liquid. Vertigo, clouded con- 
fused feeling in the head. General sense of pros- 
tration as if it were impossible to make any exertion ; 
feels too weak to talk aloud. Backache. 

Colltnso.: Leucorrhcea with pruritus, obstinate 
constipation and piles. 

Kreas. : Leucorrhcea with great debility, especially 
of the lower extremities. The discharge flows in- 
termittently. Both bland and ichorous discharges, 
causing excoriation and itching. 

Puls. : Burning, thin, acrid leucorrhcea. Milky 
or thick white mucous leucorrhoea. 

Sepia : Green-red fluid discharged from the 
vagina. Leucorrhoea like pus, or milk, excoriating 
thighs and flowing only during the day time. Pro- 
fuse mucous foetid discharge with drawing pains in 
the abdomen. Much itching in the vagina. 

Sabina : Corrosive leucorrhoea making the 
thighs sore and causing intense itching. Yellow, 



74 AN OBSTETRIC MENTOR. 

ichorous foetid corrosive leucorrhcea with itching of 
the pudenda. 

Pruritus Pudendi. 

This troublesome affection is among the most 
•obstinate which can befall a pregnant woman. For- 
tunately it is not very common, but when met it 
will tax the resource of the doctor and the spirit of 
his patient to the utmost. Guernsey uses no local 
treatment : most other authorities advise a great 
variety. Water, warm or cold (as the patient pre- 
fers) is useful. Glycerine, medicated with Cantharis 
tincture for the vesicular forms, or Urtica urens 
tincture for the erythematous or Hydrastis tinc- 
ture for the aphthous, is also recommended. 
For this latter, however, we prefer the first centes- 
imal or second decimal of Hydrastin, triturated 
with corn starch instead of sugar of milk, and ap- 
plied locally as a toilet powder.* 

Compare Ars., Bor., Calc. carb., Carbol. ac, Col- 
linso., Con., Graph., Hydrast., Kreas., Lye, Merc. 
5., Nat. mur., Sep., Sil., Sulph., Thuja. 

Arsen.: Chronic eczematoics pruritus : aphthous 
inflammation of the genital mucous membranes. 

Borax.: Aphthae of the external genitals. Cor- 
rosive leucorrhcea, thick and white like starch. 

Calc. carb.: Itching and stitches in the inter- 
nal and external genitals, either or both. Consti- 
tutional symptoms of Calc. Women who bear un- 
healthy hydrogenoid children. 

Carbol. ac: Mucous tubercles on the labia 
and inside of the thighs, with itching relieved by 
scratching but it soon returns. Feels as if she had 
taken cold : is cold and aches all over. 

* This is a most excellent application in infantile intertrigo. 



AN OBSTETRIC MENTOR. 75 

Collinso. : Violent itching of the genitals, parts 
badly swollen, dark red and protruding. Uterine 
displacements. All her trouble seems to co??ie from 
obstinate constipation and piles. 

Con.: Violent itching of the vulva followed by- 
pressing down of the uterus. Intermittent urina- 
tion. Acrid milky leucorrhcea. 

Graph.: Itching with vesicles or excoriation. 
Pimples, smartiiig and painful on the labia. Painless 
pimples inside of the labia. 

Hydrast.: Excoriation and itching of the 
vulva from extreme debility. Tenacious viscid leu- 
corrhcea. 

Kreas.: Corrosive itching of the vulva with 
soreness and burning after scratching from foetid 
corrosive leucorrhoea. 

Lyc: Great sense of dryness of the parts with 
much itching. Constipation. Ascarides. 

Merc, s.: Aphthous or eczematous pruritus. 
Itching of the vulva aggravated by a single drop of 
urine : it must be washed off. Pimples or tubercles 
on the labia, which are particularly troublesome at 
night. Very often the remedy. 

Nat. mur. : Itching of the vulva and falling off 
of the hair upon the genitals and head. Pimples on 
the mons veneris. 

Sabin.: Pruritus with leucorrhcea.* 

Sepia : Swelling and humid itching eruptions on 
the inner labia. Very much itching of the vulva. 
Leucorrhcea and bearing down. Constipation with 
sensation of a weight in the anus. Do not give Sepia 
at night. 

Sil. : Itching of the vulva with acrid leucorrhoea. 

* See Leucorrhoea. 



76 AN OBSTETRIC MENTOR. 

Constipation, stool advances to the verge of the 
anus and then recedes. 

Sulph.: Troublesome itching of the vulva with 
pimples all around* Violent itching of the clitoris. 

Thuja : Itching of the vulva when walking. 

Chloasma, or Liver-Moth. 

The skin of pregnant women is very subject to a 
dirty brown discoloration, which is supposed to 
come from the liver. 

Compare Ant. crud., Cauloph., Con., Lye, Sep., 
Sulph. 

Ant. crud.: Hepatic spots. Brown liver-colored 
spots on each shoulder. Light brown dots on the 
arms. 

Cauloph.: Brown-yellow spots on the face. 

Con.: Chronic, frequently recurring brown-red 
spots on the body. Yellow spots on the fingers. 

Lyc: Brown spots on the abdomen. Large dark 
red spots on the legs and epigastrium. Hepatic 
spots on the chest. Painful liver spots on the 
chest and arms. 

Sep.: Brown spots on the chest and elbows sur- 
rounded by herpetic skin. Claret-colored spots on 
the neck and under the chin. Livid spots on preg- 
nant women. Yellow spots. Yellow streak like a 
saddle across the ?iose and cheeks. 

Sulph.: Yellow and brown hepatic spots on the 
back and chest. 

Cracktng of the Skin of the Abdomen. 

During the last months of pregnancy many 
women (usually primiparse) are annoyed by fissur- 

* Also Hydrastis. 



AN OBSTETRIC MENTOR. 77 

ing of the skin of the abdomen. These seams are 
often exquisitely painful and not infrequently a 
little blood fills them. Moreover they leave un- 
sightly scars. For these rents or tears (for such 
they are, the skin being pressed apart by the con- 
tinued and increasing expansion) Calendula is speci- 
fic. We give the 30th internally and use either 
lotion of the tincture or a cerate of Calendula 
locally. Cosmoline medicated with the same is 
often successful. By this means very many cases 
can be speedily relieved and often the scarring pre- 
vented. 



CHAPTER III. 

Pains in Various Parts — Varicose Veins. 

Headache is one of the most common and tor- 
menting affections to which pregnant women are 
subject. This headache may be bilious or gastric, 
congestive or neuralgic. Neuralgia in the face and 
teeth is also frequently found during pregnancy. 
Nor is the latter often benefited by the extraction 
of teeth ; whereas such procedure has been followed 
by miscarriage. 

Headache (in general during pregnancy) : i. 
Actea, Bell., Bry., Gels., Glon., Ign., Nux v., Puis., 
Sep., Spig. 2. Aeon., Cact., Calc. c, Cedr., Chin., 
Collinso., Coloc, Hydrast., Hyosc., Ipec, Iris, 
Kalm., Lept., Merc, corros., Opium, Phos., Podo., 
Sang., Sil., Stram., Sulph., Verat. alb., Verat. virid. 

Headache from and with constipation : Alum., 
Bry., Coff., Collinso., Hydrast., Lept., Nux v., Opium, 
Sep., Verat. alb. 

Headache, bilious or gastric : Bell., Bry., Calc. 
carb., Ipec, Iris., Nux v., Podo., Puis., Sang., Sep. 

Headache, congestive : Aeon., Actea, Bell., Cact., 
Gels., Glon., Hyosc, Phos., Sep., Stram.,, Sulph., 
Verat. virid. 

Headache, neuralgic : Actea, Bell., Cedr., China, 
Coloc, Gels., Ign., Kalm., Merc corros., Nux v., 
Phos., Sil., Spig. 

Prosopalgia-, i. Actea, Bell., Cact., Cedr., Chin. 



AN OBSTETRIC MENTOR. 79 

sulph., Coloc, Gels., Kalm., Merc, corros., Nux v., 
Spig. 2. Cham., Lach., Mez., Phos., Plant., Sep.,. 
Stram., Verbas. 

Odontalgia : Aeon., Apis, Bell., Bry., Calc 
carb., Cham,, Coff., Hyosc., Kalm., Kreas., Merc, 
sol., Nux mos., Nux v., Puis., Rhus tox., Sep., Staph. 

Acon.: Congestive headache or neuralgia with 
vertigo on. rising up in bed. She fears to be in a 
place of excitement or confusion. Stitching throbbing 
toothache from taking cold. After coffee. 

Actea rac: Congestive or neuralgic headache, 
over, in and behind the eyes (especially one eye) ex- 
tending to the occiput. Fulness, heat and throbbing 
in the head. Ache better in the open air. 

Alumin.: Headache (with constipation) relieved 
by lying quiet in bed. Throbbing, stitching frontal 
headache with nausea, worse going up stairs or 
stooping. 

Apis : Jumping toothache in left upper molars ; 
suddenly, involuntarily biting the teeth together. 
Swelling, redness and bleeding of the gums, with 
stinging and sore pains. 

Bell.: Headache and neuralgia. Flushed face 
and injected eyeballs. Cannot bear noise or light. She 
seems to be in a stupid or stunned condition. Right 
sided headache from 4 p. m. to 3 a. m., aggravated 
by lying down and by the heat of the bed. Pains 
come suddenly, are horribly excessive, last indefinitely, 
and go suddenly. Amelioration by sitting up, leaning 
back with the eyes closed. Toothache after eating 
and at night. 

Bry.: Headache with constipation and bilious 
symptoms. Bursting, splitting headache with dry 
parched lips and thirst. She must keep perfectly 
quiet j her eyeballs feel bruised and it is painful to- 



So AN OBSTETRIC MENTOR. 

move them or the lids or have them touched. Nausea 
on rising in bed. Toothache in sound teeth, shoot- 
ing from tooth to tooth and in the head and cheeks. 
Worse while eating, especially warm food and from 
warmth in general. 

Cactus : Congestive headache or neuralgia, 
worse on the right side, returning periodically. Heart 
symptoms. 

Calc. carb.: Headache with much dandruff on 
the scalp, with vertigo. Throbbing headache every 
morning lasting all day ; so severe that she thinks 
her head will burst or she go crazy. Worse while 
going up stairs, talking, walking, in sunshine and 
from taking cold. Better from tight bandaging, and 
lying down and closing eyes. Toothache in hollow 
teeth, around loose stumps, with sore, easily bleed- 
ing, painful gums ; worse from any change of tem- 
perature of air or food. Offensive odor from the 
teeth. 

Cedrum : Headache and neuralgia pains, wan- 
dering from place to place and returning with clock- 
like periodicity, but especially in the afternoon. Severe 
sharp, shooting pains starting from a point over one 
eye (generally the left) and extending along the 
supraorbital nerve into the head. 

Cham.: Unbearable toothache, which makes her 
very irritable ; pains of all kinds during and after 
eating or taking any thing warm in the mouth (espec- 
ially coffee). Hot swelling of the cheek. Red 
shining swelling of the gum. Pain in a whole row 
of teeth, but she can't say which one particularly. 

China : Periodic neuralgia ; pains excessive, 
from left to right, especially infraorbital and maxil- 
lary branches, worse from contact, draughts of air, 
lying down and in the night. 



AN OBSTETRIC MENTOR. 8 1 

Chin. sulp. : Paroxysm sets in daily at the same 
hour : no pain in the interval and no other derange- 
ments. 

Coffea : Congestive, one-sided headache or 
headache from constipation. Excessive agonizing 
toothache relieved by holding ice or ice-water in 
the mouth. 

Collinso.: Headache with constipation and 
piles from which all the ailments seem to come. 

Coloc: Tensive tearing pain, with heat and 
swelling, especially of the left side. Constric- 
tion and pressing in left malar bone extending 
into the eye ; worse from touch and motion ; better 
from perfect rest and external heat. 

Gelsem.: Congestive or neuralgic headaches. 
She gets blind before the headache. Sharp shoot- 
ing pains through the face, eyes and head like rheu- 
matic pains. Face heavy dark red. She appears 
stupid. Headache commencing suddenly in the neck 
and spreading over the head or vice versa. Vertigo. 
Neuralgias of the fifth nerve. 

Glon. : Whirling in the head with vertigo. Sen- 
sation of expansion in the brain as though the head 
would burst. Brain feels as if expanding in waves. 
Headache or neuralgia from exposure to the sun. 

Hydrast.: Dull frontal headache, with pains in 
the back and abdomen from constipation. 

Hyosc: Congestive headache, delirium, red 
sparkling eyes, bluish countenance. Violent tear- 
ing, pulsating toothache, causing spasmodic jerkings 
of the fingers, hands, arms and facial muscles. 
Spasms in the throat. After Bell. 

Ign.: One-sided headache, periodically, as if a 
nail were forced into the temple. Melancholy, 
hysterical women. 



82 AN OBSTETRIC MENTOR. 

Ipec: Gastric headache with nausea. 

Iris vers. : Gastric or hepatic headache, always- 
beginning with a blur before the eyes. Worse in the 
afternoon. 

Kalm.: Sun headache (like that of Glon). Ex- 
cessive right-sided faceache, especially between the 
eye and nose. Pain over the right eye (which is 
weak and watery) with vertigo. Neuralgia every 
afternoon, getting much worse at nigh't. Pressing 
toothache in the molars in the evening with or with- 
out prosopalgia. The chief remedy for the face pains 
of pregnant women. 

Kreas. : Drawing tensive pains in carious teeth 
extending towards the temple. 

Lept. : Dull frontal headache with liver symp- 
toms and constipation. 

Merc, corros. : Right-sided face-ache with 
many mercurial symptoms. 

Merc. sol. : Teeth are so sore that closing 
them (as in eating) increases the pain ; her teeth 
too long and loose. Worse at night in bed. Tooth- 
ache starting from a decayed tooth and involves the 
whole side of the face, which is red and swollen. 
salivation, lachrymation, perspiration, restlessness and 
sleeplessness. 

Mez. : Right-sided neuralgia with troublesome 
twitchings of the muscles of that side. Pains come 
quickly and leave the parts numb. Worse from 
warmth. 

Nux mos.: Toothache in front teeth as if 
wrenched out, going from right to left. Women 
with cool dry skin who do not perspire. After tak- 
ing cold in the night air or cold damp weather. 
Better from warmth. Very often indicated. 

Nux v.: Women addicted to high living, like 



AN OBSTETRIC MENTOR. 8$ 

wine, spirits and coffee, keep late hours ; or those 
who lead sedentary life. Habitual constipation and 
piles, and dyspepsia. Very irritable disposition. 
Sensation as if the skull would split. Contusive 
pain in the brain. Headache every morning on wak- 
ing, after eating and in the open air. Intermittent 
neuralgia of the face. Violent toothache with all 
sorts of pains. 

Opium : Congestive headache with constipation, 
unsteady look, thirst, dry mouth, sour eructations, 
nausea, acute hearing at night. 

Phos. : Headache from mental exhaustion ; 
chronic congestion of the brain, coldness in the 
cerebellum. Neuralgia in nervo-sanguineous tem- 
peraments. Drawing, tearing pains in the jaws, root 
of nose, temples and eyes. Vertigo. Toothache of 
a jerking, twitching nature from having hands in 
water (warm or cold). The dental periosteum is 
inflamed and tender. 

Plantago : Shooting, tearing neuralgia in the 
left jaw extending into the ear. Toothache, sore- 
ness of sound teeth while eating and rapid decay of 
the teeth. 

Podo. : Liver headache, alternating with diarrhoea, 
every morning with a flushed face. 

Puls. : Hemicrania in mild, gentle women ; worse 
at night and while at rest and in a close, warm 
room ; better in the open air and from bandaging 
the head. Pale face, no thirst, palpitation of the 
heart. Toothache, with much swelling of the face, 
better from cold food and drink and fresh air. 
Chilliness of the whole body. 

Rhus, tox.: Rheumatic (?) toothache from get- 
ting wet, relieved by external warmth. Many kinds 
of pains. 



84 AN OBSTETRIC MENTOR. 

Sang.: Right-sided bilious headache from the 
occiput, neck and shoulders to the temple, passing 
off with frequent profuse discharges of pale urine. 
Nausea and vomiting. She must be perfectly quiet. 

Sepia : Headache, with aversion to all food and 
a distressing "gone," empty feeling in the stomach and 
constipation. Headache in the morning with nausea, 
vertigo and epistaxis. Moth patches on the fore- 
head and bridge of the nose, sallow complexion. 
Pain in terrific shocks as of powerful jerks in the 
head. Chronic congestive headaches with photo- 
phobia and ptosis. Right-sided hemicrania with 
nausea and vomiting. Intermittent faceache with 
the congestive headache. Beating, stitching tooth- 
ache which extends to the ears, and even the arms, 
leaving a numb, creeping sensation there. 

Sil. : Headache from nervous exhaustion, re- 
lieved by heat but not by pressure. Pain in occiput 
ascending to vertex and supraorbital region. 

Spig.: Headache commences every morning at 
sunrise, increases till noon, and decreases till sun- 
set, even in cloudy weather. Pains darting from 
behind forward through the eyeball. Headache 
and neuralgia left-sided. Neuralgia very seVere in- 
volves eyeball and orbit, the eye being much con- 
gested. Pains relieved by firm pressure. 

Staph.: The teeth turn black (also Kreas.), 
loose, brittle and carious. She is very sensitive to 
mental or physical impressions. 

Stram. : Neuralgia; pains maddening; spas- 
modic starts and shocks through the body, throws 
arms upward. Deliriiwi with open eyes, fancies she 
sees reptiles, vermin, etc. 

Sulphur : Headache with local congestions. 
Heat in top of head and flushes of face, cold feet 



AN OBSTETRIC MENTOR. 85 

and vertigo when going up stairs. Spells of faint- 
ness. Psoric. cures when other drugs fail. 

Verat. alb.: Headache with delirium, dementia 
and cold sweat on forehead. Indigestion, nausea 
and vomiting, diarrhoea or constipation. 

Verat. virid.: Congestive headache from the 
nape of neck to supraorbital region. High fever ; 
threatening puerperal convulsions, mania or fever. 

Verbas. : Periodic right-sided headache and 
neuralgia, with vertigo and great aggravation from 
the slightest pressure. 

Pains in the Breasts. 

Many women suffer much pain in the breasts, 
both during early and late stages of pregnancy, 
owing to the increasing development and activity of 
these sensitive organs. 

Bell.: Erysipelatous swelling, hardness and 
redness of the breasts, which feel heavy and very 
tender. If one be worse, it is the right one. 

Bry.: Breasts swollen in hard lumps and feel 
heavy, but are not red. Thirst, fever and desire 
to be quiet. 

Carbo an.: Breasts swollen in red nodosities, 
with tenderness and induration of the axillary 
glands. Bitter taste in the mouth. 

Cimicif.: Puckerings in both mammas, aching 
waving pains in left breast. Pains paroxysmal. 
Threatened abortion. Weakness and pain in back. 

Nux v.: Distensive pains in the breasts. Con- 
stipation, backache, haemorrhoids. Very irritable 
and sullen, won't answer any question. 

Secale : Stinging and distensive pains in the 
breasts. Passive uterine haemorrhage and threat- 
ened abortion. 



86 AN OBSTETRIC MENTOR. 

Sepia : Distensive pains in breasts which are in- 
flamed and troublesome. Many Sepia symptoms 
(see " Sepia " under other headings.) 

SORE NIPPLES. 

This annoyance sometimes distresses pregnant 
women, and arises like the preceding from a little 
over activity of the breast and a consequent inflam- 
mation of the nipple glands. A great variety of 
applications are advised not only to cure but also 
to prevent. Brandy and sugar, with some astrin- 
gent like alum or tannin has been used to harden 
the nipple. Nut-galls hollowed out to fit the nipple 
and soaked in brandy are advised by Uhlemeyer. 
To cure, Hydrastis or Arnica in water or glycerine, 
sweet oil and lime-water, Magnesia ointment, Green 
tea and Glycerine, Collodion, an oxide of zinc and 
arrowroot powder (one to sixteen), and even a solu- 
tion of nitrate of silver (grs. x. to § i.) have been 
recommended. Of this long catalogue only two 
numbers attract the homceopathist ; a bruised or 
injured nipple he knows needs Arnica, and for an 
excoriated or aphthous nipple he may use Hydrastis. 
But in our experience by far the most useful remedy 
is Calendula applied either in water, glycerine or 
cerate, as the physician or his patient may prefer. 
We think, moreover, that many of the above appli- 
cations are too severe, and instead of curing or pre- 
venting they lay the foundation for serious evils. 
Guernsey advises Graph., Lye, Petrol., Puis., Sep. 
Sil., Sulph. 

Abdominal Myalgia. 

Tensive or stitching pains in the abdominal parie- 
tes, either under the short ribs or in the inguinal 



AN OBSTETRIC MENTOR. 87 

Tegion, on one side or the other, not infrequently 
torment pregnant women. It will be necessary for 
us to distinguish carefully between these neuralgic 
.pains and those painful uterine contractions styled 
" false pains," as the remedies required in each case 
are sometimes different. 

Compare Actea, Alectris, Arm, Bell., Bry., Nux 
v., Puis., Verat. virid. 

Actea : Abdominal myalgia. Rheumatic pains 
in the muscular structures of the abdomen. Neu- 
ralgia of the abdominal plexuses. Women who suf- 
fer from rheumatism, neuralgia or dysmenorrhea j 
or who have had protracted labors from inefficient 
pains. 

Alectris: Anomalous myalgic pains in the 
walls of the abdomen simulating "false pains." 
Marked debility. Many gastric symptoms* and 
threatened miscarriage. 

Arn. : Stitches under the false ribs, arresting the 
breathing. Fine tearings in the abdominal muscles. 

Bell. : Long lasting painfulness of the whole 
abdomen. Itching stinging about the umbilicus. 
Lancinations in the inguinal glands. 

Bry. : Colic (?) of pregnant and lying-in women. 
Thoracic pains. 

Nux v. : Colic of pregnant women, with ab- 
dominal spasms. The abdominal muscles feel 
bruised when coughing, moving, laughing, or touch- 
ing the parts. 

Puls. : Abdominal spasms. Swelling and pain- 
ful sensitiveness of the abdominal walls with tensive 
pains, worse from yawning, singing, laughing, or 
-any movement of the abdominal muscles. 

* See "Alectris" under Morning Sickness, chapt. I. 



35 AN OBSTETRIC MENTOR. 

Verat. virid. : Neuralgic (?) pains at the right 
side of the umbilicus passing to the groin and also 
in the left groin. Sudden and violent thoracic and 
uterine congestions. Convulsions before, during, 
and after labor. Spurious peritonitis. 

False Pains. 

It almost invariably occurs during the last weeks 
of gestation that those uterine contractions which 
have been insensibly and periodically transpiring, 
become exaggerated, sensible, painful, and exces- 
sively annoying, frequently occasioning the woman 
to believe that the time of labor is at hand and 
summoning the accoucheur. We shall, however, 
readily perceive their false nature by the abdominal 
and vaginal touch, as we shall find no tension or 
hardness of the uterine muscles in this case, and no 
bulging of the membranes through the soft os uteri, 
and often that orifice undilated, and frequently 
much of the cervix uteri yet distinct from the body 
of the womb* If labor be at hand and the pains 
those of genuine labor all these signs will be re- 
versed. 

Consult — 

i. Cauloph. 2. Actea, Bell., Cham., CorT., Diosc, 
Gels., Hedeoma, Nux mos. and vom., Puis., Sep., 
Viburn. prun. 

Cauloph. : Pains in the hypogastrium appearing 
at nearly regular intervals ecery night about the same 
time, recurring every few moments or every hour. 
The pains may extend in the limbs and up the 
sides of the abdomen. This drug is almost specific 
for false pains, and its use is usually followed by 
easy labors. It seems to behave kindly be the pains 
false or real (labor pains) : if false it will stop them 



AN OBSTETRIC MENTOR. 89 

if genuine it will develop them and facilitate labor. 
We prefer the 3 x trituration to all other prepara- 
tions, whether higher or lower. 

Actea : * Spasmodic, neuralgic, rheumatic, 
labor-like pains in the uterus : uterine rheumatism, f 
Pain under the left breast changing to the ovary 
or arm of. the same side, or to the cervico-occipital 
region. Melancholy and threatening puerperal 
mania. Women subject to neuralgia, rheumatism, 
and hysteria ; or those who have chronic dysmenor- 
rhcea and functional dystocia. 

Bell. : Pains appear and disappear suddenly. 
The bed feels very hard to her. She cannot bear 
the least jar or noise. The back feels as if it would 
break. 

Cham. : Abdominal pains with frequent emis- 
sions of large quantities of pale urine. She feels her 
pain keenly and regards it as unbearable. Very 
irritable, spiteful, unreasonable, unhappy and lamen- 
ting. 

Coff. : Very distressing abdominal and facial 
neuralgia. She feels as if she would " go dis- 
tracted." Great mental excitement and sleepless- 
ness. Do not attempt to use Cojfea low. 

Dioscor. : False pains with violent continuous 
flatulent colic : the abdominal pains suddenly shift 
and appear in distant localities (fingers and toes). 

Gels. : Cramp-like pains in the abdomen (and 
legs), running upward and backward like those of 
commencing labor. Convulsions with complete 
unconsciousness. She feels muscularly weak, which 
arises from weak will power which cannot command 
the muscles as in health. 

* Macrotin is sometimes to be preferred, 
f See Meigs's Obstetrics, page 260. 



go AN OBSTETRIC MENTOR. 

Hedeoma : Severe periodical pains (like labor- 
pains) in the uterus, aggravated by movement and 
with a sensation of weakness or paralysis in the 
legs. The old midwives use a decoction of penny- 
royal to check false and after pains very success- 
fully. 

Nux mos. : False labor pains. Threatened mis- 
carriage. Women with cool dry skin who never 
perspire. 

Nux vom. : Abdominal spasms. Spasmodic false 
labor- (like) pains, with ineffectual urging to stool. 
Threatening miscarriage. 

Puls. : Labor-like pains which make her walk 
about (to relieve the pain). She cannot sit long at 
a time. The close or warm room oppresses her, 
she must have the window or door open, the fresh 
air is so grateful to her. She weeps and frets and 
fidgets, and is very despondent. She complains 
that the child " lies so queer," and hurts her so that 
she can only lie on her back. Do not give Puis. 
low or you will fail with it. 

Sepia : Frequent bearing down pains in the 
back and abdomen. She crosses her legs to relieve 
them. Sense of weight in the anus. Painful 
tormenting sensation of emptiness ("goneness") at 
the pit of the stomach. 

Viburn. prun. : Very painful cramp-like, labor- 
like pains in the uterus, with terrible cramps in the 
legs and abdominal muscles (and a gush of bright red 
blood from the uterus). Excessive nervous hysteri- 
cal excitement, spasms (hysterical) and threatened 
miscarriage. Women who have dysmenorrhcea. 
Viburn. is our best remedy for threatened miscar- 
riage with great nervous excitement. Palpitation 
of the heart. 



AN OBSTETRIC MENTOR. 91 



Pains in the Back. 



Pregnant women are very subject to distressing 
backaches arising from a great variety of causes. 
Consult the articles on Constipation, Haemorrhoids, 
Leucorrhcea, Uterine Displacements and Conges- 
tions, where such troubles are associated with back- 
ache. But sometimes this pain will be idiopathic, so 
to speak, arising from the increasing pressure of the 
enlarged uterus and the tension of its ligaments, or 
it may be a pure neuralgia. 

Compare : 

1. Actea, Arm, Bell., Gels., Lye, Nux v., Puis., 
Rhus tox., 2. Arg. nitr., Kali carb., Kalm., Phyt., 
Sang., Sep. 

Actea : Dull heavy aching pain in the small of 
the back, increased by motion and relieved by rest. 
Lumbago. Crick in the back. Pain and soreness 
along the spine in the ligaments and muscles of the 
vertebral column. 

Arn. : Pain in the back as if bruised or dislo- 
cated. Tingling in the back. Her back is so sore 
that she cannot bear the least motion or jar. 

Bell. : The bed feels very hard to her, and her 
back feels as if it would break. Cramp-like pain, 
or as if strained in the back. 

Gelsem. : Chilliness, chills and coldness in the 
back. Backache with occipital headache. 

Ly.c. : The foetus is unusually active. Red sand 
in the urine. Flatulent dyspepsia and constipation. 
Stiffness, aching and drawing pain in the small of 
the back. Aggravated when rising up from stoop- 
ing. 

Nux v. : She can't turn over in bed, her back is 
so lame and sore. She wakes at 4 a. m. and is 



92 AN OBSTETRIC MENTOR. 

obliged to get out of bed and walk about to relieve her 
backache. All sorts of pains in the back, especially 
in the small of the back. 

Puls. : Severe backache, which causes her to 
walk and stand very erect with the shoulders well 
thrown back. She cannot lie or sit still long at a 
time. Her pains are chiefly in the sacral region. 

Rhus tox. : Very severe backache and weak- 
ness from lifting and carrying ; the small of her 
back seems bruised and feels better by lying on a 
hard bed ; but she must move freque?itly, especially at 
night. Her back is very stiff in the morning, but is 
better after she has moved about awhile. 

Also : 

Arg. nitr. : Tensive squeezing pains in the 
back at night. Time seems to pass very slowly. 
Belching of wind after each meal until nearly time 
for the next. 

Kali carb. : Backache so that she feels as if 
she could lie down in the street while walking to 
obtain rest and relief. 

Kalm. : Aching, paralytic, rheumatic pain, as if 
the back would break ; the pains extend to the 
shoulders and arms. 

Phyt. : Lumbago. The back is stiff every 
morning. 

Sang. : Pains in the loins extending into the 
hypogastric and iliac regions and down the thighs, 
with threatened miscarriage. Pains in the sacral 
region caused by lifting. Neuralgic pains in the 
great muscles of the back. 

Sepia : Bearing down pains in the back and 
abdomen. Pains of various kinds and stiffness in 
the back. 



AN OBSTETRIC MENTOR. 93 



Cramps. 



Many women suffer severe and sudden attacks of 
cramps in the thighs, legs, or feet during pregnancy 
and mostly during its later weeks. Very rarely in 
extreme cases of nervous irritation these cramps 
affect other parts of the body. Friction will go a 
great way to relieve these spasms, and we should 
always advise rubbing upward from below, since 
that assists the circulation to its equilibrium, 
whereas the reverse action tends to stagnate the 
venous blood. The homoeopathically indicated 
remedy may be advantageously used locally in 
sweet oil, glycerine, or cerate, or, best of all, in hot 
water. 

Cramps (in general) : 

1. Actea, Camph., Cham., Coloc, Cupr., Gels., 
Rhus tox., Sulph., Verat. alb., Viburn. 

2. Calc. carb., Lye, Sec, Sep., Verat. virid. 
Actea : Cramps and even intermittent spasms 

in the extremities. Hysterical women. Sleepless- 
ness from nervous excitement. Profound melan- 
choly. 

Camph. : Cramp in the legs with desire to be 
uncovered. Her skin is as cold as marble and yet 
she feels hot and must be uncovered. 

Cham. : Severe cramps in the calves of the legs. 
She is beside herself with pain and indignation, and 
declares she " cannot and will not stand it." 

Coloc. : Severe intermittent cramps in the 
abdomen with cramps in the calves of the legs, and 
great restlessness. Cramps in the hands. If Coloc. 
fails give Diosc, which has similar symptoms with 
the distinction that the pains are continuous. 

Cupr. : Violent cramps in the fingers and toes, 



94 AN OBSTETRIC MENTOR. 

or in the stomach. Coppery taste in the mouth 
Restlessness. 

Gels. : Cramps in the legs and abdomen. 
Threatening convulsions. Muscular prostration 
arising from loss of will power. 

Rhus tox. : Cramps in the legs causing her to 
rise and walk. Cramps in the legs every night, 
she jumps out of bed and walks about. Very rest- 
less at night and can find ease but for a short time 
in any position. 

Sulph. : Cramps in the legs with hot flushes 
and weak faint spells. 

Verat. alb. : Cramps in the extremities with 
cold perspiration. She feels so very weak that she 
is obliged to lie down. Violent retching with cold 
sweat breaking out. 

Viburn. : Cramps in the legs and feet, especially 
after walking or at night. Palpitation of the heart. 
Women who have had dysmenorrhea. Threatened 
miscarriage a?id cramp-like abdominal pains. Viburn. 
is one of our best remedies for cramps. 

Also : 

Calc. carb. : Cramps in the soles of the feet or 
toes. She has hard work to get to sleep at night. 
Her feet and legs feel cold and damp. Vertigo and 
cramps while going up stairs. 

Lyc. : Cramps in the calves of the legs and cold 
feet, which sweat profusely. 

Secale : Weakness, paralysis, or spasms of the 
legs. Scrawny, ill-conditioned women. 

Sepia : Violent cramps in the calves of the legs 
at night in bed. 

Verat virid : Coldness, blueness, dampness, 
and cramps of the legs, toes, and fingers. 



AN OBSTETRIC MENTOR. 



95 



Relaxation of the Pelvic Articulations. 

It is probable that a greater or less degree of re- 
laxation of the pelvic sutures is universal during 
pregnancy, but it is comparatively rarely that it 
is the cause of much suffering or complaint. When 
our attention is called to pains and inconvenience 
in walking from which we suspect a separation of 
the pelvic bones it is usually late in the pregnancy 
in women of scrofulous diathesis. Insist upon 
absolute rest, as neglect of this precaution may 
lead to a dangerous inflammation. Use hot water 
solutions of the indicated drug locally, and con- 
sult, 

i. JEs. hip., Arm, Calc. c, Ham., Puis., Rhus 
tox., Thuja. 

2. Aloes, Calc. phos., Hep., Sil. 

^Esculus : Pain and soreness of sacro-iliac 
symphysis ; cannot walk because her back gives 
out there, she must lie down and doing so feels 
better. 

Aloes : A sense of 
pelvis seems to cause 
hsemorrhoidal sufferings. 

Arnica : Spots feel sore like a bruise. She can 
hardly move from soreness in the pubic and sacro- 
iliac symphyses. 

Calc. carb. : Leucophlegmatic constitution ; 
great fatigue on walking but a short distance, with 
a general lame feeling in pelvis. She is clumsy 
and stumbles and falls easily. Can't sleep after 
3 a. M. 

Calc phos. : Worse after taking cold, which she 
does easily, and has pains all over (in all joints). 

Hamam. : Excessive soreness and tenderness of 



weight and pressure into 
lameness, diarrhoea, and 



g6 AN OBSTETRIC MENTOR. 

pelvic articulations, but no pains. Arnica seems in- 
dicated and fails. 

Hepar. : Ulcerations with pimples about them. 

Puls. : Can't walk toward evening and feels 
worse in bed. Can't find one easy position or sleep 
all night as the pelvic articulations hurt so. 

Rhus tox. : Painful stiffness in pelvic articula- 
tions on attempting to walk, better after getting 
warm in walking. She must often change position 
at night in bed, and feels easy for a while after, but 
is soon restless and must change again. 

Silicea : Ulcerations with very tender fistulous 
openings. 

Thuja : Soreness in left sacro-iliac symphyses 
and pains also extending into groin. Pain from 
walking is so insupportable that she must lie down. 

Varicose Veins. 

We simply re-voice Guernsey in claiming that 
varicose veins can be cured by the homoeopathic 
remedy ; or if first taken in hand when very large 
and numerous, or when gestation is far advanced, 
their further development can be checked. And 
as a woman with the varicose diathesis having once 
suffered this annoyance will be subject to it in sub- 
sequent pregnancies, we have a double duty, to 
relieve the present case and remove the varicose 
diathesis, which homoeopathic remedies certainly 
will do. Where it is possible and gives comfort the 
enlarged veins should be supported by a judiciously 
applied bandage, snug, but never tight (or by an 
elastic stocking). Vulvular varices may be often 
advantageously supported by a compress (or com- 
presses), and a T bandage. A sitting or recumbent 
position should be assumed as much as possible. 



AN OBSTETRIC MENTOR. 97 

If the varices suddenly rupture apply a cold water 
compress strongly medicated with the tincture or 
fluid extract of Hamamelis and give the same in- 
ternally. Sometimes Millefolium is useful. If these 
fail use styptics. 

Varicoses : i. Arm, Carbo. v., Fluor, ac, 
Hamam., Lye, Millef., Puis. 

2. Aeon., Apis., Ars., Caust., Ferr. met., Graph., 
Nux v., Sulph., Zinc. met. 

Acon. : Advised by Richardson in alternation 
with Hamam. or Puis, for much pain and general 
febrile condition. 

Apis, : Burning, stinging pains in varicose veins, 
either with or without constipation. Profuse urine 
calls for a high dilution, scanty discharge for a low 
potency. 

Arn. : The varices feel very sore and as if 
bruised. Varices of the vulva and vagina especially. 

Arsen. : If they burn like fire. 

Caust. : They become much more painful 
when the patient is walking. 

Carbo. v. : Painful discharge or suppression of 
urine with' vaginal varices. The varices are bluish. 
This is one of our best remedies be the varices 
where they may, but must be used in 30th dilution 
or higher. 

Ferr. met. : Weakly persons with fiery red faces. 

Fluor, ac. : Obstinate cases of long standing, and 
especially in women who have borne many children. 

Graph. : Varicosities itch very much and have 
little pimples on the skin over them. Itching 
blotches on various parts of the body. 

Hamam. : Hard, knotty, swollen and painful 
varicose veins. Ruptured varices which bleed terribly. 
The legs are chiefly affected. 



98 AN OBSTETRIC MENTOR. 

Lyc. : Varicose veins of the lower limbs, extend- 
ing nearly to the feet ; they feel large and hard 
under the finger. Red sandy sediment in urine. 
Borborygmus and constipation. 

Millef. : Ruptured varices whose bleeding is 
not checked by Hamam. The bleeding from the 
bursted veins is attended by uterine haemorrhage. 
The varices are painless. 

Nux v. : In women who keep late hours, use 
wines and highly seasoned food, and suffer from 
constipation and gastric derangements. 

Puls. : The chief remedy for varices dwing preg- 
nancy. Pain in varices (and general symptoms), 
worse toward evening ; the veins have a blue ap- 
pearance. Women who cry easily and are of mild 
disposition. 

Sulph. : Varicose veins of extremities or vulva, 
with haemorrhoidal sufferings. Other Sulph. charac- 
teristics, such as morning diarrhoea, etc. 

Zinc. met. : Varicose veins which give rise to 
fidgetiness of feet and limbs. 



CHAPTER IV. 

Sensory, Nervous and Mental Affections, 
Vertigo and Plethora, Insomnia and Neu- 
roses. 

Old fashioned allopathy assigned multitudes of 
physical sins to Plethora, and sought their allevia- 
tion by bleeding. More recently we diagnose from 
the same phenomena, vertigo, localized congestions 
and even uraemia and impending convulsions. 

Pregnant women often suffer vertigo and faint- 
riess, for which advise bathing face and head with 
cold water, cool acid drinks and rest in bed. 

Vertigo Repertory. * 

In morning hours : Calc. c, Nat. mur., Nux v., 
Phos., Rhus tox. 

In evening hours : i. Bell. 2. Cyclam., Lach., 
Puis., Sep., Zinc. 

When lying down : 1. Ars., Aur. met., Cyclam., 
Pulsat. 

When rising up : Con., Lach., Nux v., Rhus tox. 

When walking : Caps., Con., Lye, Phos., Puis. 

When stooping : Bry., Calc. c, Sep., Spig. 

With empty stomach : Calc. c, China, Iod., 
Phos. 

* Compare also Gastric derangements, headaches, Cardiac 
palpitation and Albuminuria. 



IOO AN OBSTETRIC MENTOR. 

After eating : Calc. c, Lye, Nat. mur., Nux v., 
Phos., Sep. 

After Sleeping : Apis, Lach., Nux v., Phos., Sep. 
In fresh air : Coca, Nux mos., Nux v., Sil. 
In the room : Agar., Ars., Puis., Sil. 
Better by motion : Caps., Cyclam., Lye, Puis., 
Rhus tox. 

Better by rest : Bell., Colch., Nat. mur., Nux v. 
Revolving vertigo : Am., Bry., Phos. Nux v. 
Stupefying vertigo : Bell., Calc. c, Hyosc, Sil. 
Staggering vertigo : Aeon., Nux v., Plat., Rhus 
tox. 

With trembling and uneasiness : Aeon., Ars., 
Calc. c, Ign., Phos. 

With fainting : Aeon., Ars., China, Nat. mur., 
Nux v., Phos. 

With vomiting : Ars., Ipec, Nux v., Puis.. 
Verat. alb. 

With tendency to fall — a (forward) Cicuta, 

Phos. ac, Spig. 
b (backward) Bry., 
China, Nux v., Rhus 
tox. 
c (sideways) Con., 
Ipec, Sil., Sulph, 

Loss of Hearing. 

Rarely cases will be seen of sudden or gradual 
loss of hearing during pregnancy not associated 
with any recognizable otological lesion. The best 
course is to consult an ear specialist. Where that 
is impossible or inadvisable, compare 

i. Capsic, Carbo an., Caust., Graph. Kali iod., 
Lach., Merc, s., Nitr. ac, Phos., Puis., Sil., Sulph. 

2. Calc. c, Hep., Petrol., Staph. 



AN OBSTETRIC MENTOR. IOI 

Guernsey gives : 

Capsic. : The petrous portion of the ear is 
much smaller, red and painful. 

Carbo an. : She is able to hear, although faintly, 
but cannot tell from whence the sounds proceed. 

Caust. : Reverberation of all sounds, even of 
the patient's own voice, in the ears. 

Graph. : Great dryness in the ears. The deaf- 
ness is better when riding in a carriage. 

Lach. : The cerumen is too hard, too pale and 
insufficient. 

Merc. : Sensation of coldness in the ears con- 
tinually. 

Nitr. ac. : Much swelling of the internal ear ; 
it is nearly closed and sometimes there is much pain 
within it. 

Phos. : Difficulty in distinguishing the human 
voice. 

Puls. : Sensation as if the ears were stopped up. 

Sil. : Partial relief is obtained by blowing the 
nose. 

Sulph. : Aggravation for a while after eating or 
blowing the nose. 

Hygienic Means : Where there is much " tinnitus 
aurium," a collection of wax upon the drum may be 
suspected. If found use a warm suds syringing, 
and that failing, a drop or two of warm sweet oil, 
Glycerine or fluid Cosmoline should be put in the 
ear. Should the ear be foetid (either with or with- 
out otorrhcea) use a warm weak solution of perman- 
ganate of potash with the syringe and Kali iod. 3 x 
internally, being very careful never to suppress the 
discharge suddenly. 



102 AN OBSTETRIC MENTOR. 



Eye Affections. 



Blindness (partial or complete) and many pains 
about the eyes are very common to pregnant women. 
Where the former occurs ophthalmoscopic examina- 
tion should be sought at once, and if albuminurious 
retinitis exist we shall be on our guard (see page 
67) against most grave complications. We believe 
that almost all amauroses occurring during preg- 
nancy will be found to arise from diseased kidneys. 
We draw again from Guernsey : 

Aur. met. : Objects appear as if divided hori- 
zontally. 

Bell. : Dim appearance of objects ; they appear 
inverted or double. 

■ Calc. c. : All objects appear as if seen through 
a mist. 

Caust. : Sudden and frequent loss of sight, with 
a sensation of a film before the eyes. The dimness 
of vision is greater after every headache. Paralysis 
of the upper eyelids so that they hang down. 

China : She can only distinguish the outlines of 
distant objects. When reading the letters appear 
pale and surrounded with a white border. She sees 
better after sleeping. 

Cicuta : The letters seem to move about when 
she is reading. 

Cina : She can see more clearly for a while 
after rubbing the eyes. (Eupbras. also). 

Hyosc. : Frequent spasms of the eyelids — stra- 
bismus. All objects appear of a red color or larger 
than they are. 

Nat. mos. : Frequent spasmodic closure of the 
lids. 

Nux v. : Heaviness and contraction of the lids. 



AN OBSTETRIC MENTOR. IO3 

Phos. : All objects appear to be covered with a 
gray veil. 

Puls. : Sensation a? if the eyes were covered 
with a mist, or as if the dimness could be removed 
by rubbing something off from the eye. 

Sulph. : Dimness of vision and the gas or lamp- 
lights appear to be surrounded by a halo. 

Also: Cyclam., Dros., Glon., Merc, Ruta., 
Senega, Sep., Verat. alb. 

Insomnia. 

When a pregnant woman is sleepless either she is 
unhappy, excessively nervous, or else some physical 
cause may be found. Sometimes too violent mo- 
tions of the foetus keep her awake, (see page 127). 
She sleeps in an illy ventilated room, perhaps, or 
retires too early or too late ; or she has some bad 
habit of life, or some physical ailment. First then 
find out why she cannot sleep and remove that 
"why," and all will be well. If the cause can not 
be found regulate all living habits very strictly and 
compare : 

1. Aeon., Bell., Coff., Hyosc, Ighat., Mosch., 
Opium. 2. Ambr., Cact., Cham., Chin., Gels., Lye, 
Nux v., Puis., Rhus tox., Staph., Strain. 

Acon. : Sleeplessness after midnight with anx- 
iety, restlessness and continued tossing about. Eyes 
closed but no sleep, says, " / shall not live through 
it" 

Ambr. : Cannot sleep at night, yet knows not why. 

Bell. : Drowsy all the evening and after going 
to bed, but cannot sleep. Starts up from a nap as 
if frightened (compare Stram.) A colleague of 
great experience in nervous diseases, says, " Bell. 
low is the great remedy for sleeplessness." 



■■ 



104 AN OBSTETRIC MENTOR. 

Cactus : Sleeplessness without cause or from 
pulsations in the pit of the stomach or in the ears. 

Cham. : Scarcely ever sleeps, and on falling 
asleep is tormented by anxious frightening dreams. 

China : She lies awake all night thinking, rest- 
less and uneasy, and is miserable next day. Or if 
she drops asleep she wakes in a profuse perspira- 
tion. 

Coffea : Sleeplessness from over excitement of 
body or mind ; from joy or surprise or long watch- 
ing. She is wide awake and has no desire to sleep. 
We have been very successful with this drug. 

Gels. ; Languid, drowsy, but cannot compose 
the mind for sleep. 

Hyosc. : Drowsiness without sleep. She starts 
from her sleep and cannot sleep again. She has 
bad dreams, or sleeps very heavily, or talks in her 
sleep. She imagines something is in the room and. 
is afraid (compare Stram.) Irritable, nervous, easily 
excited woman. She cannot sleep because of a short 
hacking cough all night which is absent during the 
day. 

Ignat. : She is very nervous, and lies thinking 
about herself and other cares and anxieties. She 
weeps or laughs alternately, and if she sleeps at all 
it is a light, restless slumber during which she hears 
everything, even distant sounds (compare Opium). 
She complains in the morning that she is not rested ; 
her mind is weary. 

Lyc. : Drowsy by day and sleepless by night. 
Sleep restless, is easy in no position ; cries out, starts 
and jerks her limbs about. The child moves about 
so constantly and vigorously that she cannot sleep. 
If she sleeps and wakes, she is hungry, cross and 
unreasonable, and in the morning unrefreshed. 



AN OBSTETRIC MENTOR. 105 

Mosch. : Sleeplessness from nervous excitement 
without any other ailment. Is sure she is about 
to die. 

Nux v. : vVakes at 3 a. m. and lies awake for 
hours with a rush of thoughts ; falls asleep in the 
bright daylight with troublesome dreams and gets 
up tired and dispirited. 

Opium : Stupid sleeplessness (Gels.), with great 
acuteness of hearing. If she sleeps she has frightful 
visions, especially before midnight. 

Puls. : Sleeplessness after a too late or hearty 
supper. She sleeps late in the morning. 

Rhus tox. : Sleepless and restless, must often 
change position, especially before midnight. 

Staph. : Sleepy all day, awake all night ; body 
aches all over. 

Stram. : Restless disturbed sleep : she starts up 
in a fright and says there are rats or snakes under 
the bed. At times deep sound sleep. 

Hysteria. 

Fortunately pregnancy does not often give rise to 
hysteria unless the woman has already a tendency 
towards the disorder. It is, however, very com- 
monly seen during gestation, since many women are 
subject to it at all times, and doubly so when preg- 
nant. In fact, many women have hysterical con- 
vulsions or spasms, interspersed with what might 
almost be styled an hysterical mania, during the 
first seven or eight months of pregnancy ; the true 
puerperal convulsions occurring almost exclusively 
either shortly before, during, or soon after the 
actual labor. Compare especially for 

Hysteria: t. Asaf., Aur. met, Cocc, Con. 



106 AN OBSTETRIC MENTOR. 

Gels., Ign., Magn. mur., Mosch., Nat. c, Nux v., 
Plat., Valer. 

2. Anac, Ars., Bell., Cal. c, Cauloph., Caust., 
Camp, monobrom., Cann. indie, Cham., Coff., 
Hyosc, Nat. mur., Nux mosch., Pall., Puis., Sab., 
Sep., Sticta., Stram., Sulph. 

Anac. : Great forgetfulness. Loss of memory. 
Uses profane language. 

Ars. : Hysterical asthma developed by every 
little excitement ; worse at night after midnight. 
She cannot lie down for fear of suffocation. She 
wants a little water every few moments. Great fear 
of death. 

Asafclt. : Much trouble about the oesophagus ; 
burning and dryness in it. Sensation as of pressure 
or as if a lump was ascending in the oesophagus. 
She has to be constantly swallowing to keep it 
down. This sensation causes great dyspnoea. 

Aur. met. Desire to kill herself ; she thinks 
and. talks of little else. Fine eruption on the face, 
forehead, or lips. Palpitation of the heart. The 
Arsenic patient fears but expects death ; the 
Aurum case longs for death and expects it, even to 
seeking suicide. 

Bell. : Cerebral congestion ; face and eyes very 
red before and during the spasms. Throbbing 
frontal headache. Sleeplessness (see preceding 
section). Plethoric women. 

Calc. carb. : Women of a leucophlegmatic 
temperament. Feet and legs feel cold and damp, 
especially at night in bed. She cannot go to sleep 
at night for thinking. She cannot sleep after three 
o'clock in the morning. Vertigo on going up 
stairs. 

Camp, monobrom. : Hale advises this drug low 



AN OBSTETRIC MENTOR. IO7 

for hysteria, hysterical spasms, and cerebral con- 
gestions during pregnancy. 

Cann. Indic. : Extreme nervous prostration or 
irritability (or both). Short distances (as from one 
room to another) seem eziormous, and she dreads to 
attempt to traverse them. Vertigo, faintness, and 
a nameless distress referred to gastric and cardiac 
regions. Metrorrhagia, sleeplessness, nightmare. 
Many dreams, vivid and frightful. 

Cauloph. : Hysteria and women subject to 
epilepsy and dysmenorrhea. Severe frontal head- 
ache in spells. Moth spots on the forehead. Anae- 
mia. 

Ca'ust. : Cannot keep upper eyelids up : eyes 
feel sore and as if they had sand in them : sight 
dim as if looking through a mist. Piles, enuresis 
nocturna. She looks on the dark side of every 
thing. 

Cham. : Exceeding sensibility to pain and extra- 
ordinary irritability of temper. She has to restrain 
herself so as to answer any one with civility. 

Coccul.: Choking constriction in the upper part 
of the fauces with dyspnoea and disposition to 
cough. Roaring in the ears. 

Coffea : Great sensitiveness and excitability. 
She is in a state of ecstasy. Sleeplessness. 

Conium : Vertigo in a recumbent position. 
Globus hystericus. Intermittent micturition. 

Gelsem. : Hysterical convulsions with spasms 
of the glottis. Stupor with muscular prostration. 
Occipital headache and afternoon fever. 

Hyosc. : Disposed to uncover herself and go 
naked. Much silly laughter and many foolish actions. 
Thinks all food and drink are poisoned and refuses 
them. Jerking and twitching in the spasms. 



108 AN OBSTETRIC MENTOR. 

Ignat. : Spasms with sighing, anguish, shrieking 
for help. Suffocating constriction of the throat. 
Quiet silent grief antS. depression. One of our best 
remedies. 

Magnes. mur. : Many spasms day and night 
with great sleeplessness. Hysterical spasms which 
stop her labor pains. Fainting fits at table, nausea 
and trembling, relieved by eructations. Constipa- 
tion, (Lilienthal says: "one of our best remedies 
in the 200 dilution") of large difficult stools crum- 
bling as they pass the verge of the anus. Guernsey 
recommends as : " one of the most important reme- 
dies " in hysteria. 

Mosch. : Scolding, long, loud, and vehement, 
frequent fainting ; continual prating of her death 
and its near approach. Great desire for stimulants. 

Nat. carb. : Worse at night. Full of fancies 
all night. Sadness. Irritability. Inclination to 
start. 

Nat. mur. : She wakes in the morning with a 
bad headache. Somnambulism. Inclination to 
weep. She says " something awful will certainly 
happen." She witnessed a frightful sight which 
she cannot get out of her mind. She dreamed 
robbers were in the house and will not be satisfied 
until it is searched. 

Nux Mosch. : Sudden changes from grave to 
gay and vice versa. Excessive tendency to laughter. 
Abdomen extended excessively after meals. Mouth 
and tongue dry after sleeping. Frequent fainting 
and tendency to abortion. Excessive dyspnoea. 

Nux vom. : She wakes at 3 a. m., and lies awake 
until daylight, goes to sleep and lies late ; and feels 
badly when she finally wakes. Dyspepsia and 
constipation. Obstinate and will not speak to any one. 



AN OBSTETRIC MENTOR. 109 

Pallad. : She imagines herself neglected : 
wounded pride. Uses much strong language and 
many violent expressions. Flatulently distended 
abdomen. Constipation and chalky stools. 

Platina : Self-exaltation : she looks down with 
contempt on every body : she feels as if getting big 
physically, Spasms with wild shrieks. Stools diffi- 
cult, adhering like clay to the anus. 

Pulsat. : Feelings and symptoms very variable 
and change often. Flat slimy taste, very intolera- 
ble in the morning, so that she must wash out her 
mouth. Constant chilliness and great disposition 
to weep. 

Sabina : Very nervous and hysterical and dis- 
posed to abort about the third month. 

Sepia : Involuntary fits of laughter and weeping. 
" Goneness " at the pit of the stomach. Paroxysms 
of something twisting about in her stomach and 
rising toward her throat. Urine putrid and deposits 
a clay-colored pediment which adheres with great 
tenacity to the vessel. 

Sticta. : Hysteria after loss of blood. Hysterical 
Chorea. Headache, which noise and light aggra- 
vates. 

Stram. : Strange and absurd fancies. She thinks 
rats and reptiles are under the bed and will not be 
persuaded but looks to see. She is very talkative 
and desires light and society. Awakes with a scream 
and a frightened and fixed stare. 

Sulph. : She co?nes out of her spasms very happy, 
and everything seems beautiful. Copious micturi- 
tion announces the termination of the spasms. Head 
hot and painful on top. Hungry before dinner can 
be gotten. 

Verler. : Fearfulness, trembling and palpitation, 



IIO AN OBSTETRIC MENTOR. 

sensation as if something warm were rising from 
her stomach into the throat ; or as of a thread 
hanging in the throat ; tickling in the throat and 
coughing. 

Chorea. 

Women who have suffered attacks of chorea (or 
even hysteria) will be likely to suffer from it during 
gestation. Rarely idiopathic cases (so to speak) 
will be seen during pregnancy. 

Consult : i. Agar., Actea rac, Cauloph., Caust, 
Coca, Croc, Cupr. met., Hyosc, Ign., Lauro, 
Nux v., Sticta, Stram., Verat. virid. 

2. Bell, Calc. c, Cicuta, Secale, Silicea. 

Actea : Left sided chorea from rheumatism or 
uterine troubles. Irregular, tumultuous, strange 
movements of the heart. Spinal irritation. Loss 
of speech. 

Agar : True cerebral chorea, with congestion, 
dilated pupils, flushed face. Twitching of volun- 
tary muscles when awake but quiet when asleep. 
Nictitation of eyelids. 

Bell. : Cerebral chorea from hyperemia ; reflex 
chorea from pregnancy. Right side especially : diffi- 
culty in articulation and deglutition. Incontinence 
of urine. Face and eyes red. 

Calc. c. : Chorea from fright. 

Cauloph. : Chorea during pregnancy. 

Caust. : Right side. Eyes distorted. Tendency 
to aphonia or other paralyses. See also " Hysteria." 

Cicuta : Sudden rigidity with jerking of the 
limbs ; or twisting and distortion of limbs with 
screaming. 

Coccul. : Always worse after eating, drinking, 
sleeping or talking. After Nux v. 



AN OBSTETRIC MENTOR. I I I 

Croc. : Worse in evening : alternations of affec- 
tionate tenderness and excessive rage. Jumping, 
dancing, laughing, whistling. Wants to kiss every- 
body. Epistaxis or metrorrhagia : blood dark and 
stringy. 

Cupr. met. : Chorea minor : the paroxysm 
begins in one part and spreads over whole body. 
Terrible contortions with laughter, grimaces, and 
exultation. She cannot speak. After fright. Bet- 
ter when lying. Often on one side only. 

Hvosc. : Twitching and jerking of muscles all 
over, aggravated by eating. Disposed to laugh and 
act and talk foolishly. 

Ignatia : Chorea from fright, grief, or mental 
excitement : worse after eating. See Hysteria. 

Lauro : She tears her clothing and strikes at 
everything. Spasmodic deglutition. Indistinct ar- 
ticulation. She is furious because not understood. 
Incessant motion. She cannot stand, sit or lie. 
Gasping for breath. After fright. 

Nux v. : Numbness and crawling in affected 
parts. After dragging. Worse in the morning. 
See Constipation. Coccul. follows well. 

Secale : Choreic motions beginning in face and 
spreading all over even to jumping and dancing. 

Silicea : Chorea from ascarides. Pale face, 
canine hunger, irritated nostrils, constipation. Sleep 
full of dreams and horrors. 

Sticta : Hysterical Chorea. She cannot keep 
her feet to the ground : they jump and dance about 
in spite of all efforts to control them. When she 
lies down her limbs feel light as feathers as if 
floating in the air. See Hysteria. 

Stram. : Choreic motions of the leg of one 
side and arm of the other : or of the lower extrem- 



112 AN OBSTETRIC MENTOR. 

ities. Frequent putting hands to genitals. Indina- 
nation to pray. Loss of speech and memory. Or, 
furious motions and emotions : laughter, lamentations, 
efforts to escape, hallucinations. Compare Hys- 
teria. 

Verat. v. : Chorea Magna, which is almost con- 
vulsions in severity. Champing of the teeth. Sex- 
ual excitement. Full, hard, bounding, rapid pulse. 

Disorders of the Affections, Emotions and 
Feelings. 

The peculiar mental conditions developed by 
pregnancy are often among those most harassing 
to the patient and puzzling to her attendant. A 
little kindly given advice to both husband and wife 
as to forbearance, good nature, diversion, etc., will 
often do more than drugs. Nevertheless the mate- 
ria medica is full of jewels of mental symptoms 
which will richly reward the diligent seeker. The 
following repertory is offered, not as covering all 
possible mental conditions during pregnancy, but, 
merely as including those commonly observed. 

Aggravation in the dark : Cann. indie, Stram. 

Aggravation in the evening : Arn., Bell., Coloc, 
Hyosc, Lach., Lye, Phos., Plat., Puis., Sep. 

Aggravation in the morning : Aur., Nat. mur., 
Nux v., Phos. 

Aggravation in the night : Aeon., Arn., Ars., 
Con., Nat. mur. 

Anger, effects of : Bry., Cham., Coloc, Nux v., 
Staph. 

Appearance as if stunned : Bell., Gels. 

Changeable disposition, from sad to gay, or vice 
versa : Asaf., Coff., Ign., Nux mos., Phos., Puis , 
Zinc. 



AN OBSTETRIC MENTOR. 113 

Complaining and reproachful : Lye, Mosch., 
Nux v., Plat. 

Confidence, none in herself and thinks others 
have none : Aur. 

Contradictory humor : laughs at the sad and is 
sad at the gay : Anac. 

Death, foretells the day of her : Aeon., Mosch. 

Demon, thinks she is a : Anac. 

Demon, thinks every one is a : Plat. 

Discontent with her condition, does not want 
any baby, hopes it will die, and she miscarry, etc. : 

Ign. 

Disgust, estrangement, from individuals, or so- 
ciety, even from husband and family : Actea, 
Anac, Con., Nat. carb., Nat. mur. 

Fear of abortion : Nux mos. 

Fear of an incurable condition : LiL, Sep. 

Fear of death : Aeon., Actea, Apis, Ars., Coff., 
Gels., Kali carb., Mosch., Lye, Sec, Stram. 

Fear of being poisoned : Hyosc. 

Fear of an undefined or undetermined something 
terrible which will happen : Aeon., Calc carb., 
Ign., Hyosc, Nat. mur., Sep. 

Fear she will become insane : Cann. indie, LiL, 
Nux v. 

Fear that she will be thought insane : Calc 
carb. 

Fear of being left alone : Ars., Lye, Stram. 

Fears about her health : Ars., LiL, Sep., Staph. 

Fright, effects of a : Aeon., Bell., Gels., Hyosc, 
Ign., Nat. mur., Opium, Plat., Verat. alb 

Fright from a disgusting or horrible sight, of 
which she cannot help thinking constantly : Nat. 
mur. 

Gaiety and frivolity : Arm, Croc, Stram. 



114 AN OBSTETRIC MENTOR. 

Grief, effects of : Ign., Phos. ac, Staph. 

Happiness, thinks she has beautiful things ; 
awake at night singing, she is so happy : has happy 
dreams : Sulph. 

Haughty, overbearing, full of contempt : Lye, 
Plat., Verat. alb. 

Home, thinks she is away from it : Opium. 

Ideas, strange and ridiculous : Anac, Stram. 

Impatient : Ign., Ipec, Merc. sol. 

Inconstancy : Actea, Ign. 

Indifference : Nux mos., Phos. ac, Sep. 

Irresolution : Ign., Lach., Nux mos., Nux v., 
Puis. 

Irritability : Bry., Carbo veg.,Cham., Gels., Ign., 
Ipec, Iod., Kali carb.. Lye, Merc, sol., Mosch., 
Nat. mur., Nux v., Phos., Sep., Sulph. 

Joy, effects of : Aeon., Coff., Sulph. 

Jealousy, suspicion : Actea, Hyosc, Lach. 

Memory, loss of : Anac, Zinc. 

Melancholy, grieving : Aeon., Actea, Ars., Aur., 
Calc carb., Bell., Caust, Ign., Lach., Lye, Nat. 
mur., Nux .v., Puis., Sep., Verat. alb., Ustil. 

Mischievous : Arm, Calc carb. 

Noise, intolerance of : Bell., Ign. 

Obstinacy : Bry., Calc carb., Nux v. 

Past events trouble her : Calc. sulph., Plat. 

Pins, occupied with and hunts for : Sil. 

Prayerfulness, excessive : Stram. 

Quarrelsome : Ign. 

Solitude, desire for : Actea, Anac, Ign., Nux v. 

Swearing, inclined to : Anac. 

Suicide, desire to commit : Aur., Ars., Nux v., 
Rhus tox. 

Taciturn, silent : Calc. c, Ign., Nitr. ac, Nux v., 
Phos. ac, Verat. alb., Zinc. 



AN OBSTETRIC MENTOR. I I 5 

Talkative, vivacious : Croc, Gels., Hyosc, 
Lach., Strain., Sulph. 

Thinking impossible, mind dull : Anac, Nux v. 

Visions, frightful : Bell., Stram. 

Wandering about the house, desire for : Nat. 
mur., Verat. alb. 

Weeping, disposed to : Aur., Ign., Kali carb., 
Phos., Puis., Sep., Staph., Sulph. 

Violent Fcetal Movements. 

Not infrequently women suffer during the last 
three months of gestation from violent and inces- 
sant movements of the foetus ; and we certainly 
think that the over-active child may often be 
■quieted by a judiciously selected remedy. Study 
carefully the condition of the woman and taking 
any abnormalities into full consideration compare 
the following : 

Too violent or incessant fcetal movements. 

1. Arn., Lye, Puis. 

2. Con., Opium, Psor., Sep., Thuja. 

Diathesis. 

We believe that the unborn child may be radi- 
cally influenced by the homceopathically applied 
drug, so as to prevent or at least modify the disease 
tendencies which it is likely to inherit from its 
parents. Therefore we advise : study the constitu- 
tions and peculiarities of both parents (especially 
the mother) and give her the drug or drugs in a 
not low potency which specially antagonize the forms 
of dyscrasia which it is desired to overcome. Give 
the remedy sparingly ; once in three days or a 
week. 
To Modify Diathesis Study: 



Il6 AN OBSTETRIC MENTOR. 

i. Calc. carb., Calc. iod., Calc. phos., Calc. silic, 
Sil., Sulph. 

2. Phos., Phos. ac, Psor., Rhus tox., Syphil. 

3. Bar. carb., Bar. mur., Caust, Hepar, Nux v., 
Sepia. 

Hygiene. 

Every physician should inculcate, in the minds 
of his patrons, a sense of the advantage of profes- 
sional supervision to every pregnant woman from 
the moment conception is known to exist. That 
point gained, attention should be given not alone to 
physical abnormalities but also to engendering the 
best hygienic conditions. Bathing is an essential : 
tepid sponge-baths, and, if the woman can endure 
it without a shock, cold water applied to the genitals 
and breast. Cold water is a tonic (Nature's own), 
and women who use it as advised rarely have rigid 
perinaeums, agued breasts, or sore nipples. The 
sitz-bath is warmly advocated by many. We have 
had but little experience with it and, having found 
a purely natural bath all sufficient, adhere to the 
latter. 

Diet should be widely varied, never heavy and 
always palatable. An exclusive fruit diet we do 
not advise : because after a faithful observation of 
it in a considerable number of cases, we do not 
find it doing what has been claimed for it. On the 
other hand, a carefully selected diet certainly does 
help not only in averting an extremely difficult 
labor, but also in producing a healthy child. Stim- 
ulants of all kinds, coffee, spices, pickles, etc., and 
salt food should be avoided. Whole wheat, brown 
or graham bread, eggs, fruit, and vegetables of all 
kinds in profusion, soups and broths should be the 



AN OBSTETRIC MENTOR. 117 

staples. Of meat not much and then the flesh of 
young animals. Rice and sago, and in a less degree 
barley, oats and rye may also be used. But be it 
understood that we do not approve an exclusive 
diet, although advising the predominance of such 
as we have indicated. For drinks, none excel soft 
or distilled water and lemonade ; if tea is used it 
should be black. " *The key to a comfortable happy 
pregnancy and the subsequent bringing forth (by a 
not difficult labor) of a healthy intelligent child, is 
flenty, but not too much food in variety, exercise of 
mind and body, literature, art, religion, in just and 
harmonious proportions." — Those wishing to study 
this subject further, should consult Verdi's Matern- 
ity, Holbrook on Painless Parturition, Richard- 
son's Obstetrics, and Hale's Diseases of Women. 

Functional Dystocia. 

When a woman has been subject to dysmenor- 
rhoea, we expect a difficult labor and endeavor to 
avert it. Questioning the woman closely we try and 
find out what were the full symptoms of her men- 
strual trouble : these fitted by a similimum, other 
things equal, said similimum will avert a hard labor. 
We use the drug or drugs during the last six or 
eight weeks of pregnancy twice or three times a 
day, and usually find our helper from among the 
following : 

1. Actea, Cauloph., Puis., Viburn. op. 

2. Bry., Cham., Collinso., Helon., Nat. mur., 
Plat., Sep., Verat. virid., Xanthox. 

*See Author's paper, " Horn. Journ. Obstet." Vol. 2, page 
-175. 



CHAPTER V. 

Miscarriage or Abortion. 

The worst ill which can afflict a pregnant woman 
is a threatened loss of the imperfected product of 
conception, whether it be styled miscarriage or pre- 
mature labor. When therefore the enciente one 
complains of uterine pains, with or without down- 
ward forcing sensations, or when any bloody flux is 
noticed from the genitals, it is a warning of impend- 
ing disaster not to be disregarded. Let every 
woman so affected be put upon her back and kept 
there until the danger is past or the exfoliation of 
the foetus completed. Verdi, the woman's friend, 
advises that where a woman has aborted at any 
given time she keep quiet upon her back for two 
weeks before and after said time, and be watched 
by her physician : good advice. Of course if we are 
certain the foetus is dead, we shall hasten its dis- 
charge from the uterus by all means in our power. 
If, moreover, we find the membranes or foetus par- 
tially expelled, or even protuberant, from the uterus, 
we should by tht hand or ovum forceps extract the 
whole in the shortest possible time, directing our 
remedial treatment towards the haemorrhage. 

Treatment Abortion :* i. Actea, Arm, Bell., 
Cauloph., China, Cinnam., Ipec, Kali carb., Puis., 

* See Fright, etc., under Disorder of Affections. 



AN OBSTETRIC MENTOR. II9 

Sabin., Sep., Sec, Viburn. op. 2. Aeon., Alect., 
Apis, Arn., Bry., Calc. c., Cham., Croc., Ferr., Gels., 
Helon., Hyosc, Lye., Nux mos., Nux v., Rhus tox., 
Sil., Tril., Ustil. 

Pains predominating : Actea, Arn., Cauloph., 
Cham., Gels., Nux v., Puis., Rhus tox., Viburn. op. 

Haemorrhage predominating : Aeon., Bell., China, 
Cinnam., Croc., Hamam., Ipec, Millef., Sabin., Sec, 
Trill., Ustil. 

Haemorrhage after abortion : China, Hamam., 
Millif., Nux mos., Trill. 

Early months of gestation : Apis, Viburn. op. 

Later months of gestation : Opium. 

First month : Viburn. op. 

Second month : Apis, Kali carb. 

Third month : Croc, Sab., Sec, Thuja. 

Fifth to seventh month : Sepia. 

Discharge black : Asar., Croc, Kreas., Plat., 
Puis., Secale. 

Discharge black and coagulated : Cham., Chin., 
Croc, Puis., Sabin., Ustil. 

Discharge thin, black and with foul smelling clots : 
Secale. 

Discharge black and stringy : Crocus. 

Discharge black, in gushes : Puis. 

Discharge black and thick : Plat. 

Discharge black and offensive : Cham., Croc, 
Kreas., Secale. 

Discharge coagulated : Arn., Bell., Cham., Chin., 
Croc, Ferr., Helon., Ipec, Plat., Puis., Sabin., Sec, 
Ustil. 

Discharge comes and goes suddenly : Bell. 

Discharge continuous : Arn., Cinnam., Ham., 
Hyosc, Ipec, Sabin., Ustil. 

Discharge continuous but not profuse : Ustil. 



120 AN OBSTETRIC MENTOR. 

Discharge continuous with nausea : Ipec. 

Discharge dark : Bell., Bry., Cham., Chin., Ferr., 
Helon., Kreas., Nux mos., Plat., Puis., Sabin., Sec, 
Trill., Ustil. 

Discharge dark and coagulated : Bell., Cham., 
Chin., Croc, Ferr., Puis., Sabin., Sec, Ustil. 

Discharge dark fluid : Bry., Plat., Secale. 

Discharge dark and offensive, or foetid : Bell., 
Cham., Croc, Kreas., Sabin., Sec, Ustil. 

Discharge dark and thick : Nux mos., Plat. 

Discharge in gushes, bright red : Cham., Chin., 
Puis., Sabin., Sec, Ustil. 

Discharge hot, bright red : Bell. 

Discharge intermittent : Chin., Kreas., Puis. 

Discharge passive : Alect., Cauloph, Chin., Croc, 
Ham., Helon., Sec, Ustil. 

Discharge profuse : Apis., Am., Bell., Cham., 
Chin., Cinnam., Croc, Erig., Ferr., Helon., Ipec, 
Hyosc, Sabin., Sec, Trill. 

Discharge bright red : Arm, Bell, Cinnam., Erig., 
Hyosc, Hamam., Ipec, Millef., Sabin., Trill., Ustil. 

Discharge bright red, continuous : Hyosc, Ipec. 

Discharge bright red, intermittent : Bell., Rhus 
tox., Sabin., Ustil. 

Discharge bright red, not coagulating : Hamam. 

Discharge bright red, with clots and coagulating : 
Am., Bell., Ipec, Sab., Ustil. 

^Discharge Scanty : Cauloph., Nux v. 

Discharge coming on suddenly : Bell., Cinnam. 

Discharge watery : Chin., Ferr., Kreas., Sabin., 
Sec 

Discharge watery, with clots : Chin., Ferr., 
Sabin., Sec. 

* Compare " Pains predominating," page 157. 



AN OBSTETRIC MENTOR. 121 

Discharge worse from motion : Coff., Croc, 
Erig., Sabin., Sec. 

Pain in back as if it would break : Bell., Kali. c. 

Pain in back drawing : Rhus tox. 

Pain in back, extending through to pelvis : 
Sabin. 

Pain in back, extending into thighs : Actea, 
Kali. c. 

Pain in back, paralytic, legs almost useless : 
Cocc. 

Pain in back, severe in back and loins : Cauloph. 

Pain in small of back : Asar., Bell., Calc. carb., 
Lye. 

Pain in small of back with great weakness : 
Kali. c. 

Pain in back, intolerable before urinating : Lye. 

Pain in back, worse by motion : Bry. 

Pain in uterine region, colicky : Bell., Calc. c, 
Chin., Sep. 

Pain in uterine region, colicky, with desire to 
urinate : Cham. 

Pain in uterine region, cramplike ; Cocc, Nux 
mos., Viburn. 

Pain in uterine region, cramplike with cutting 
stitches : Ign. 

Pain in uterine region, exciting desire to defecate : 
Nux v. 

Pain in uterine region and distention : Chin., Lye 

Pain in uterine region coming and going sud- 
denly : Bell. 

Pain in uterine region with faint sick sensation 
in abdomen : Sabin. 

Pain and heaviness in uterine region : Cham. 

Pain in uterine region, labor-like and alternating 
with haemorrhage : Cham., Puis., Secale. 



122 AN OBSTETRIC MENTOR. 

Pain in uterine region, labor-like : Actea, Apis, 
Bell., Calc. c, Cauloph., Cham., Hyosc., Ipec., Kali 
c, Nitr. ac, Nux v., Opium, Plat., Puis., Sabin., 
Sec., Sep., Ustil. 

Pain in uterine region labor-like as if pelvic con- 
tents would issue through vulva : Bell., Nitr. ac, 
Sep. 

Pain in uterine region, labor-like, extending into 
back and thighs : Kali c. 

Pain in uterine region, labor-like, extending into 
ovarian region : Podoph. 

Pain in uterine region, labor-like, extending into 
hypochondrion : Cham. 

Pain in uterine region, labor-like, extending into 
thighs : Apis, Cham., Kali c, Sang., Viburn. 

Pain in uterine region, labor-like and periodical : 
Cham. 

Pain in uterine region, labor-like, shooting across 
abdomen from right to left : Lye. 

Pain in uterine region, labor-like, spasmodic : 
Cauloph. 

Pain in uterine region, labor-like, from urging : 
Arn. 

Pain and motion in uterine region as of some- 
thing alive ; Croc. 

Pain, great restlessness, and agony referred to 
uterine region : Cham. 

Pain in uterine region shooting to legs : Viburn. 

Pain in uterine and stinging in the ovarian region : 
Apis. 

Sinking empty sensation in uterine region : Ign., 
Sep. 

Tremulous sensation in uterine region : Plat. 

Great weakness in uterine region : Phos. 

Weight in uterine region : Alect. 



AN OBSTETRIC MENTOR. 12^ 

Pain about umbilicus passing off into the uterus : 
Ipec. 

Abortion from anaemia : Alect., Calc. carb., 
China, Ferr., Helon., Kali carb., Plumb., Puis., 
Secale. 

Abortion from uterine congestion : Actea, Alect., 
Bell., Canth., Cauloph., China, Croc, Hep., Nux 
vora., Sepia. 

Abortion from passive uterine congestion : Cau- 
loph., Secale, Ustil. 

Abortion from uterine congestion with ulceration : 
Canth. 

Abortion from constipation : ^Escul., Apis, Bry., 
Collinso., Nux vom., Sil. 

Abortion from Cystitis : Aeon., Cann. sat., Canth. 

Abortion from cold or damp : Aeon., Dulc, 
Puis., Rhus tox. 

Abortion from fright : Aeon., Gels., Opium, 

Abortion from Hysteria : Cann. indie, Cauloph., 
Nux mos., Sabin. 

Abortion from gonorrhoea : Cann. sat. 

Abortion from indurations of cervix uteri : Aur., 
Con., Sepia. 

Abortion from uterine inertia : Actea, Alect., 
Cauloph., China, Ferr., Helon., Puis , Sabin., Sec, 
Ustil. 

Abortion from lead poisoning : Plumb. 

Abortion from leucorrhcea : Calc. carb., Camp., 
Lye, Sep., Sulph. 

Abortion from nervous sensibility : Asar., Camp.- 
mono-brom., Ferr., Plat. 

Abortion from plethora : Aeon., Apis, Meet., 
Calc. carb., Sabin. 

Abortion from shocks, falls, concussions : Arm, 
Cinnam., Con., Rhus tox. 



124 AN OBSTETRIC MENTOR. 

Abortion from a strain in the loins, misstep or 
over exertion : Cinnam., Rhus tox. 

Abortion from typhoid fever : Bapt. 

Abortion from stimulants, drugs or narcotics : 
Bell., Hepar., Nux vom. 

Abortion from rheumatism : Actea, Cauloph., 
Rhus tox. 

Threatened Septicaemia after abortion : Arm, 
Ars., Bapt. 

For the most frequently useful remedies we sub- 
join, Particular Indications. 

Actea : Habitual abortion, with cold chills and 
pricking pains in breasts. Women of rheumatic 
tendencies. Marsden alternates it with Ergot in 
cases of retained secundines. Pain predominant. 

Arnica : In case of a fall, shock, bruise or con- 
cussion a pregnant woman should always take Arnica, 
not too low. Flowing without pain, pain without 
flow ; or both pain and flow. She feels bruised and 
sore ; it hurts her to move and the child hurts her 
when it moves and feels as if it lay across the ab- 
domen. Pain predominates. 

Belladonna : Backache as if it would break 
with severe pressing down as if the pelvic contents 
would issue through the vulva. Congestive headache 
and red face and eyes. Profuse hot hemorrhage. 
The least jar, or noise or light are insupportable. 
Haemorrhage predominates. 

Caulophyllum : One of our best remedies to 
arrest the abortive process. Severe pain in back and 
loins with great want of uterine tonicity. Feeble 
uterine contractions and very slight hemorrhage. 

Cinnamon : Profuse flow of bright red blood 
after a strain in the loins or a false step. Hemor- 
rhage predominates. 



AN OBSTETRIC MENTOR. 125 

Gelsemium : Sharp, distressing pains run up- 
ward or upward and backward. Abortion from 
sudden depressing emotions with diarrhoea. Pain 
predominates. 

Kali carb. : Abortion at the second month 
(third?). Pains begin in back and go down thighs 
like stitches. Backache when walking. She feels 
that she must sit or lie down. Pain predominates. 

Nux mos. : Obstinate, long continued flooding 
after abortion. Hysterical women disposed to 
fainting attacks who greatly dread and fear an 
abortion. Dry mouth and throat (especially after 
sleeping) . Hemorrhage predominates. 

Opium : Abortion threatened after a fright. 
Spasmodic labor pains. Latter part of pregnancy. 
Pain predominates. 

Pulsatilla : Flowing is intermittent (also 
Kreas.) Black blood passed with labor pains : the 
pains and haemorrhage alternate. Pain predomi- 
nates. 

Rhus tox. : Abortion from a wrench, strain, 
a ?nissiep or from lifting (lifting also, Calc. c.) 
Pains in the last part of the night, she is restless. 
Cramps in legs. Pain predominates. 

Sabina : Abortion at the third month, violent 
forcing or dragging pain extending from the back 
through to the pubes. Profuse bright red or dark 
fluid and clotted discharge. Haemorrhage predom- 
inates. 

Secale : Abortion at the third month, with co- 
pious black foetid fluid discharge and convulsive 
movements. Feeble women who have borne many 
children. 

Trillium : Delicate anaemic women subject to 
uterine displacements. Flow mostly bright red, 



126 AN OBSTETRIC MENTOR. 

more rarely dark and clotted. Haemorrhage pre- 
dominates. 

Ustilago : Passive long continued haemorrhage 
after abortion. Huge clots or lumps of blood. 
Bearing down pains and profuse flow, either dark or 
bright, and almost always clotted. A very valuable 
and too often neglected remedy in which haemor- 
rhage predominates. 

* Viburn. op. Spasmodic pains shooting from the 
uterus into the legs. Frequent and early miscarriages ; 
the ovum is expelled at the fourth or sixth week, 
thus causing a seeming sterility : We have repeatedly 
verified the symptom — Labor like pains of extraor- 
dinary severity. With Arn. and Cauloph. Viburnum 
ranks as among the best of remedies for abortion in 
which pain predominates. 

In case the similimum is not found above con- 
sider further : 

Acon. : Fright and the fear remains. Haemor- 
hage with fear of death. Great excitement mental 
and physical. Unconscious and apparently un- 
reasonable fear controls her. Haemorrhage predom- 
inates. 

Alectris far. — Habitual abortion, with sensa- 
tion of weight in uterine region and prolapsus uteri. 
Anaemia, haemorrhage predominates. 

Apis. — Stinging pains in ovarian region, followed 
by pain and flowing. Urine scanty (low dilution) 
or profuse (high dilution). No thirst. Prolonged 
and difficult constipation. Abortion early in 
gestation, (second month). Pain predominates. 

Cantharis. — Constant {sometimes ineffectual') de- 
sire to urinate, only a few drops passed at a time 

* See page 117 " Viburnum." 



AN OBSTETRIC MENTOR. 1 27 

with cutting burning pain. (Compare Cann. 
sat., Equiset. and Nux vomica.) Pain predomi- 
nates. 

Chamomilla. — Pains and dark clotted haemor- 
rhage with frequent profuse urination. Spiteful, 
snappish irritability. Pain predominates. 

China. — Sensation as if abdomen were " bloat- 
ed " full : passage of flatus up and down without 
relief. Profuse bright red haemorrhage (especially 
after abortion) with most alarming prostration : 
She is wiconscious , pulseless, breathless, limp and 
pallid. Such cases cinchona will often rescue. 
Haemorrhage predominates. 

Crocus. —Sensation as if something alive mov- 
ing in the abdomen, with nausea, faintness and 
haemorrhage, which is caused by the least move- 
ment. Black strings of blood with little knots, or 
clots, upon them. Haemorrhage predominates. 

Ipecacuanha. — Incessant nausea. Pain about 
the umbilicus passing into the uterus, with profuse 
bright red haemorrhage predominating. 

Kreasote. — Intermittent (also Pulsatilla) dark 
offensive corrosive discharge after abortion. Pro- 
lapsus uteri after abortion (also Helonias and 
Podophyllum). 

Nux vomica. — Every pain produces a desire to 
defecate and urinate, especially the former (the 
latter Catharsis). Constipation, dyspepsia and 
dysuria, soreness in uterine region. Very irritable 
and dreads to move or be moved. Pain predomin- 
ates. 

Podophyllum. — Pain in the ovarian regions 
every night, disturbing sleep, making her nervous 
and restless, and finally inducing abortion. Prolap- 
sus uteri (especially after abortion or confinement) 



128 AN OBSTETRIC MENTOR, 

the womb falls very low, painfully so. Pain pre- 
dominates. 

Sepia. — Habitual abortion from the fifth to sev- 
enth month. Sensation of weight in the anus with 
constipation. Painful empty " gone " sensation in 
the stomach. The fcetal movements are very feeble. 
Yellow spots on face (yellow saddle across nose). 
Pain predominates. 



CHAPTER VI. 

The Pains of Labor. Rigid and Contracted 

Os Uteri, and Hour-Glass 

Contractions. 

The variations of labor pains from a normal 
standard, are very many, frequently encountered, 
and easily overcome by the similimum. Dr. E. M. 
Hale has well pointed out the absurdity of con- 
founding the rigid and the spasmodically contract- 
ed os uteri, and his distinction we observe. Hour- 
glass contractions are usually only found retaining 
the placenta ; but we have seen one case of such 
constriction about the waist of the unborn child 
preventing its delivery ; and instances have been 
observed of its occurrence after the placental deliv- 
ery. 

Pains ceasing : i. Actea, Bell., Cauloph., Kali 
carb., Opium, Puis., and Sec. 2. Cham., Gels., 
Nat. mur., Nux v., Ruta, and Sepia. 3. Arm, Bor., 
Camph., Carb. v., Chin., Cocc, Graph., Ignat., Lye, 
Magn. mur., Nux v., Plat., Sulph., and Thuja. 

Pains, distressing : 1. Cham., Gelsem., Kali carb., 
Sepia. 2. Aeon., Actea, Arm, Aur., Bell., Coff., 
Con., Lye, Nux v., Secale. 

Pains, spasmodic : 1. Cham., Gelsem., Hyosc, 
Puis. 2. Actea, Ambra, Bell., Cocc, Cupr. met., 
Ipec, Lye, Nux v., Sepia, Viburn. 

Pains, too weak : 1. Actea, Bell., Cann. s 



130 AN OBSTETRIC MENTOR. 

Cauloph., Gelsem., Kali carb., Opium, Puis., Secale. 
2. Cham., Nat. mur., Nux v., Ruta., Sepia. 3. 
Arm, Bor., Camph., Carbo v., China, Cocc, Graph., 
Ignat., Lye, Magn. mur., Nux v., Plat., Sulph., Thuja. 

Pains, too strong : Bell., Cham., Coff., Cact., 
Nux v., Puis., Sec. 

Aconitum : Great distress swooning and rest- 
lessness with each pain (and after ?). She fears 
that she will not be delivered or that she will die, 
or that something will certainly go wrong. The vulva, 
vagina and os are dry, tender and undilatable. 

Actea : She complains the pains are of a tear- 
ing distressing character and not located properly 
to effect expulsion. Rheumatic women. Great 
nervous excitement with very violent spasmodic 
pains. 

Arnica : With each pain flushed face and heat 
of head while the rest of the body may be cool. 
The pains are so violent as to drive her almost dis- 
tracted and yet little is accomplished. She feels 
very sore and bruised in any position and must often 
change her position, with very feeble pains. 

Aurum met : The pains make her desperate 
and she would like to jump out of the window and 
dash herself down ; congestion to the heart and 
chest and palpitation of the heart. 

Belladonna : Pains come on and go off sud- 
denly. Spasmodic contraction of the os uteri which 
is hot dry and tender : the labor is slow and tedious 
and the os uteri does not dilate in proportion to the 
pains. Face red and eyeballs injected. 

Borax : Pains accompanied by violent and fre- 
quent eructations. She fears a downward motion. 
Very sensitive to any noise, as rustling of paper, 
attling of a door latch, etc., etc. 



AN OBSTETRIC MENTOR. 131 

Camphor. : Her pains have ceased and her skin 
is cold, dry and shrunken ; she does not like to be 
covered and is restless. 

Carbo. veg : The pains are too weak or cease 
from great debility. Varicose vulva. After great 
loss of animal fluids, or other debilitating effects of 
previous or existing disease. 

Caulophyllum : False pains. Extraordinarily 
rigid os uteri : (spasmodic contraction). Severe 
spasmodic pains without progress : pains flag from 
long continuance and exhaustion, thirst and fever. 

Causticum : Distressing sore pain in her back 
is her chief complaint. After debility, night watch- 
ing, grief or some depressing influence. 

Chamomilla : Spasmodic distressing pains. She 
can hardly bear them : she wishes to get away from 
them. She is very fretful, peevish and cross, and 
can't return a civil answer. Tearing pains down 
the legs. She is spiteful or cries out sharply. 

China : When much blood has been lost, or 
there has been fainting, fits or convulsions. Ces- 
sation of pain from loss of vital fluids. She can't 
bear to be touched (even her hands) during a pain. 

Cocculus : Spasmodic irregular paralytic pains : 
a hard pain and then after a longer interval several 
lighter ones. Much headache. Numb paralyzed 
feeling in the lower limbs. 

Coffea : Pains insupportable to her feelings : 
she feels them intensely and weeps and laments 
fearfully. Although severe the pains are not effica- 
cious. 

Conium : Scirrhosis in the breast or uterus. 
Pains spasmodic : vertigo on turning in bed : 
spasmodic contraction of the os uteri. 

Cuprum met : Violent spasmodic pains at ir- 



132 AN OBSTETRIC MENTOR. 

regular intervals, with severe cramps in the lower 
extremities ; or cramps in fingers and toes only. 
Great restlessness between the pains. 

Gelsemium : Cutting pains in the abdomen 
from in front and below, upward and backward, 
rendering every labor pain useless. Rigid os uteri. 

Graphites : Large corpulent women of venous 
constitution ; tettery eruptions. Pains weak or lost. 

Hyoscyamus : Delirium : startings and jerkings 
all over face, eyelids, etc. Pains spasmodic and 
contracted os uteri. 

Ignatia : Deep sighs and sadness ; she must 
take a deep breath to breathe at all. Hysterical 
symptoms. Pains too weak or ceasing. Rigid os 
uteri ? 

Ipecacuanha : Constant nausea. With each 
labor pain a sharp cutting about the umbilicus 
darting off to the uterus, which renders the pain 
useless. 

Kali carb. : Pains begin in the back and pass 
off down the buttocks. Sharp cutting pains across 
the lumbar region, arresting the labor pains. She 
is greatly disturbed by sharp stitching pains. 

Lycopodium : During the paroxysms of her pain 
she is obliged to keep in motion. Spasmodic con- 
traction of the os uteri. 

Magnesia mur. : The labor pains are inter- 
rupted by hysterical spasms. 

Natrum mur.: Very sad and foreboding. Pains 
too feeble. 

Nux mosch. : Very drowsy and sleeping: faint- 
ing spells : pains slow and feeble or suppressed. 

Nux vom.: Every pain causes vesical and rectal 
tenesmus and fainting. 

Opium : Pain suppressed by fear or fright. 



AN OBSTETRIC MENTOR. 133 

Soporous condition with red face, injected eyes and 
stertorous breathing : twitching and jerking of the 
muscles. 

Platina : Very painful sensitiveness of the 
vagina, external genitals (and os uteri ?) interrupts 
the labor pains. Spasmodic, very painful, inefficient 
pains. Her thoughts horrify her. 

Pulsatilla : Inertia uteri. (Arnica fatigue of 
the uterus.) Pains excite palpitation, suffocating 
and fainting spells.* (She must have the doors and 
windows wide open.) No thirst, very slow labor. 
Abnormal presentations may be righted if the drug 
is exhibited in a potency before the membranes are 
ruptured or the presenting part firmly engaged. 

Rut a : Lame and sore all over : very weak 
feeble contractions. 

Secale : Weak cachectic women, or those debil- 
itated from venous haemorrhage or by frequent and 
repeated child bearing. Weak, suppressed or very 
distressing pains. Fainting. Do 7iot give in a ma- 
terial dose until the os uteri is well dilated (if so at 
all) as it sometimes causes spasmodically contracted 
os and retained placenta. 

Sepia : Shuddering attends the pains and she 
wants to be covered up more as she can bear the 
pains easier so. Induration felt upon the uterine 
neck. Shooting pains in the neck extending up- 
ward. Spasmodic contraction of the os uteri. A 
Colleague has repeatedly verified every one of these 
symptoms. 

Sulphur : Flushes of heat, frequent weak faint 
spells, wants more air. Cold feet, heat on top of 
the head. 

* We have confirmed this symptom with six separate dilu- 
tions of the drug : 3X, 30, 200, 1000, Cm., and M. 



134 AN OBSTETRIC MENTOR. 

Thuja : Syphilitic troubles which hinder con- 
tractility. 

Viburnum : False pains preceding the real 
pains. Cramps in the abdomen shooting down the 
legs. Spasmodically contracted os uteri. 

Rigid os uteri : Gelsem., Ignat., Lobel. inflate 
Nux v., Passiflora, Tart, em., Verat. virid. 

Gelsemium : False pains from before back and 
up, interrupting the labor pain. Cramping pains in 
various parts of the abdomen. Os uteri round, 
hard, thick, rigid and undilatable. Face dark 
flushed. Women stupid and apathetic. 

Ignatia : Where Nux v. seems indicated and 
fails ; or the Ignatia mental state is marked (see 
previous section). 

Lobelia : Thick leathery unyielding cervix 
uteri with nausea with each pain. She has such 
violent dyspnoea that the pain is useless. 

Nux v.: Pains in the loins causing constant 
urging to stool with a tendency to tetanic rigidity 
of the os uteri. 

Passiflora (curare) : Almost tetanic rigidity of 
the os uteri in hysterical subjects. 

Tartar emetic : Rigid os uteri with much 
nausea and dyspnoea, especially in women with 
history of sub-acute or chronic pelvic inflamma- 
tions. 

Verat. virid : Rigid os uteri with threatening 
convulsions : plethora, pulse full, hard and quick. 
Head and chest congested. 

Spasmodic Contraction of the Os Uteri. 

Spasmodic contraction of the os uteri : Aeon., 
Actea, Amyl., Bell., Cact., Cauloph., Con., Hyosc, 
Lach., Morp. acet., Viburn., Xanthox. 



AN OBSTETRIC MENTOR. 135 

Aconitum : Great heat and dryness of the vag- 
ina and os uteri, which is contracted and undilat- 
able. Restless, anxious and discouraged after the 
drug. 

Actea : Severe spasmodic ineffectual pains : 
rheumatic diathesis. Dr. Marsden advises chiefly 
for rigid os : Dr. Hale gives as a remedy for spas- 
modic contraction : irregularly constricted os ; at 
one time dilating and dilatable, then suddenly 
closed by spasm. Melancholy and nervous, irritat- 
ing choreic motions all over. 

Amyl.: Spasmodic pains and constriction of the 
os uteri : flushing with each pain and severe head- 
ache. 

Belladonna : Heat and tenderness of the parts : 
swooning : flushed face, eyes injected : quick mo- 
tions : pains come and go suddenly : one of our best 
remedies. 

Cactus : Women who suffer heart spasm (of the 
circular fibres) and dysmenorrhoea. 

Caulophyllum : Spasmodic inefficient pains in 
various parts of the abdomen. She is much ex- 
hausted. Or, severe contractions of the fundus 
and constriction of the os uteri. Do not give low 
in these cases. 

Conium : See Conium, page 136. 

Hyoscyamus : When Belladonna fails : compare 
Hyosc, page 136. 

Lachesis : Contracted os with throat and heart 
symptoms : women near climacteric. 

Morphia acet.: Excessive pain and uncontroll- 
able nervous irritation. Spasmodic constriction 
of the os uteri. Dr. Hale prefers the valerianic 
salt. 

Viburnum : Violent pains and cramps in the 



136 AN OBSTETRIC MENTOR. 

legs, thighs and abdomen. Spasmodic contraction 
of the os uteri. 

Xanthoxylum : Sandy haired delicate women 
who have had dysmenorrhcea, ovarian troubles, 
headaches, amenorrhcea and chronic coughs 

Hour-Glass Contractions. 

Hour-glass contractions : 1. Bell., Cham., Kali . 
carb., Plat., Secale, Sepia. 

2. Coca, Con., Cup. ars., Hyosc, Nux v., Pulsat., 
Rhus tox., Sulph. 

Belladonna : Almost constant moaning which 
seems to afford relief ; injected eyeballs ; flushed 
face ; can't bear light or noise ; pulse full and 
bounding ; very hot skin. 

Chamomilla : Distress which it seems she can 
hardly endure ; spiteful irritability ; thirst ; desires 
fresh air ; restlessness ; more or less discharge of 
dark blood from the vagina. 

Cocculus : Terrible pain in the small of the 
back ; lower limbs feel paralyzed ; frequent vomit- 
ing. 

Conium : Vertigo when turning the head ; very 
sensitive across the abdomen. 

Cuprum ars.: Violent and distressing cramps in 
the uterine region ; and in the hands and feet. 

Hyoscyamus : Delirium ; jerking and twitching 
of the muscles ; bluish color of the face. 

Kali carb.: Distressing pain in the back run- 
ning down into the buttocks ; stitching pain in the 
abdomen ; abdomen bloated with wind ; restless- 
ness and thirst. 

Nux vomica : Sore aching pain in the region of 
the uterus ; very frequent inclination to stool ; 
great mental depression and nervous irritability. 



AN OBSTETRIC MENTOR. I37 

Platina : Very great sensitiveness of the organs, 
severe cramping pain in the uterine region ; con- 
stant oozing of dark grumous blood from the vagina. 

Pulsatilla : Very mild, tearful women ; desires 
fresh air ; very restless ; absence of thirst. 

Rhus tox.: Occasional paroxysms of pains ex- 
tending down the posterior surface of the limbs ; 
restlessness with relief after every change of posi- 
tion ; must change position frequently. 

Secale : A sensation of constant tonic pressure 
in the uterine region, causing great distress ; wishes 
fresh air and don't like to be covered much. 

Sepia : Numerous little darting pains shooting 
upward from the neck 'of the uterus ; flushes of 
heat ; cold feet. 

Sulphur : Frequent weak fainty spells ; wishes 
to be fanned : flushes of heat and cold feet. 



CHAPTER VII. 

HEMORRHAGE. 

Haemorrhage : i. Aeon., Apoc. can., Arg. nitr., 
Bell., Bry., Calc. carb., Cham., China, Cinnab., 
Cinnain., Croc., Erigeron, Ferr., Hamam., Hyosc., 
Ipec, Kali carb., Lach., Millef., Nux. v., Sabina, 
Secale, Sepia, Silic., Sulph ., Sulph. ac, Trill, 
Ustilago. 

2. Actea, Alectris, Ant. crud., Apis, Arn., 
Ars., Canthar., Carbo veg., Cauloph., Ign., Iod., 
Kreas., Lye., Nitr. ac., Nux mosch., Phos., Platina, 
Puis., Rhus tox., Stram. 

Active Haemorrhage : Aeon., Apis, Arn., Croc, 
Hamam., Ustilago. 

Haemorrhage alternating with labor pains : Pul- 
sat. 

Continual Haemorrhage : Apoc. can., Ipec, Secale, 
Ustilago. 

Bright red continual Haemorrhage : Hyos., Ipec. 

Dark, suddenly appearing Haemorrhage : Ars. 

Haemorrhage continual or in paroxysms : Apoc. 
can. 

Intermitting Haemorrhage with uterine cramps, 
colic and painful distention of the abdomen : China. 

Oozing of Dark Blood with small coagula for 
days : Ustilago. 

Painless Haemorrhage : Bov., Calc. carb., Ha- 
mam., Magn. carb. 



AN OBSTETRIC MENTOR. ■ 1 39 

Passive Haemorrhage : Alectris, Cauloph., Carbo 
veg., Croc, Hamam., Plumb., Secale, Ustilago. 

Paroxysmal Haemorrhage, brought on by the 
slightest motion : Sabina. 

Periodical Haemorrhage : Arg. nit., Ipec. 

Profuse Haemorrhage : Apis, Bell., Bry., Calc. 
card., Cauloph., Cham., Cinnam., Eriger., Hamam., 
Helon., Kreas., Millef., Nux v., Sabina, Secale. 

Profuse Haemorrhage, long lasting : Phosph. 

Profuse Haemorrhage between the after pains : 
Bell. 

Profuse Continuous Haemorrhage : Ipec. 

Profuse Dark Haemorrhage : Sepia. 

Profuse Dark Clotted Haemorrhage : Trillium. 

* Profuse Haemorrhage during abortion : Arn., 
Cham., Ipec., Pals., Sepia, Sabina, Secale, Viburn. 

Profuse Haemorrhage in gushes : Hamam., L Ipec, 
Viburn. 

Profuse Haemorrhage, in gushes at every effort to 
vomit ; gasping for breath ; faintness : Ipec. 

Profuse Haemorrhage of bright red blood, at the 
least motion : Trillium. 

Profuse sudden Haemorrhage : Cinnam. 

Profuse Haemorrhage, thin, partly black, coagu- 
lated : Ferrum. 

Profuse Haemorrhage of equal parts, clotted^or 
fluid, dark or bright : Sabina. 

Profuse Haemorrhage with easy bearing down 
pain : Cyclam. 

f Scanty Haemorrhage : Cocc, Nux. v. 

Haemorrhage Worse from Motion : Arg. nit., 
Calc. carb., Coff., Croc, Plumb., Sabin., Secale, 
Trill. 

* Compare " Abortion," page 119. 

f Compare " Pain Predominating," under Abortion. 



140 AN OBSTETRIC MENTOR. 

Haemorrhage worse from the least motion, but 
better from walking : Sabina. 

Haemorrhage worse from the least jar : Bell. 
Haemorrhage worse from mental excitement : 
Calc. carb. 

Haemorrhage worse when vomiting or trying to 
do so : Ipec. 

Black Blood : China, Elaps, Kreas. 

Black Clotted Blood (See also Clots) : Arundo 
m., Cham., China, Croc, Ferr., Lye, Puis. Sabina. 

Black Liquid Blood : Secale. 

Black Stringy Blood : Crocus. 

Bright Red Blood : Arn., Bell., Calc. carb., 
Cinnam., Diadema, Erecthilis, Hamam., Hyosc, 
Ipec, Lye, Millef., Rhus tox., Sabina. 

Bright Red Consta nt Flux : Hyosc, Ipec, Mil- 
lef. 

Bright Red Hot Flux ; Bell. 

Bright Red Lumpy Flux : Am., Ustilago. 

Bright Red Lumpy Flux, in paroxysms with 
colic : Bell., Nux v., Rhus tox. 

Bright Red Partly Clotted Flux : Sabina. 

Brown Fluid Flux : Apoc can., Secale. 

Clots : Cham., China, Nux v., Puis., Rhus tox., 
Stram., Thlapsi bursas., Ustilago. 

Clots, partly bright red and partly bloody serum ; 
Lye. 

Clots, Dark : Cham., China, Ustilago. 

Clots Dark in paroxysms ; Pulsat. 

Clots Dark, alternating with bloody serum : 
Plumb. 

Clots hard and black, mixed with fluid blood 
passing away in a dark tarry appearance : Plat- 
ina. 

Large Clots : Apoc. can., Stram. 



AN OBSTETRIC MENTOR. 141 

Large Black Clots*. Coff., Secale. 

Large Clots in bright red blood : Arm, Ustilago. 

Large Offensive Clots : Bell., Kreas. 

Large Clots with violent pains ; increased by 
motion : Arg. nitr. 

Large Clots mixed with pale watery blood : China. 

Dark Haemorrhage : Ars., Bry., Canth., Coccul., 
Haraam., Kreas., Nitr. ac, Plumb., Secale. 

Dark Fluid Haemorrhage : Bry., Plat., Secale. 

Dark Haemorrhage, with blackish clots in thin 
watery blood : Sabina. 

Dark Painless Haemorrhage immediately after 
delivery : Nuxmosch, Plat. 

Dark Haemorrhage, profuse at first, then for a 
few days bloody ichor with pungent odor, and cor- 
rosive itching and smarting of the parts : Kreas. 

Dark Thick Haemorrhage : Nux mosch., Plat. 

Dark Clotted Profuse Haemorrhage for days : 
Trill. 

Pale Haemorrhage : Carbo veg., Hyosc, Merc. 
v., Sabina. 

Pale Haemorrhage, Clotted or very thin, offens- 
ive ; aggravated by motion ; after miscarriage : 
Sabina. 

Pale Watery Haemorrhage with coagula : China. 

Pale Watery Haemorrhage with pale lips and 
face : Ferr. 

Pale Watery Haemorrhage, more and more 
watery : Prunus spin. 

Stringy Viscid Haemorrhage, Dark or Black : 
Crocus. 

Thick Black not Coagulated Haemorrhage : 
Platina. 

Foetid Haemorrhage : Crocus, Secale,Terebinth., 
Trill. 



142 AN OBSTETRIC MENTOR. 

Offensive Haemorrhage : Bell., Cham., Croc, 
Kreas., Sabina, Secale. 

Pungent Haemorrhage : Kreas. 

Putrid Haemorrhage : Cham. 

Haemorrhage after Falls, Shocks, Concussion : 
Arn. 

Haemorrhage after Abortion : Bell., Cham., 
China, Cinnam., Croc, Eriger., Ferr., Hyosc, Ipec, 
Kali carb., Lye, Nitr. ac, Plat., Sabina, Secale, 
Silic, Symph., Thlapsi bursae. 

Haemorrhage after a Dose of Chamomile : China, 
Ignat. 

Haemorrhage after Abuse of Drugs and Coffee : 
Nux v. 

Haemorrhage after a Dose of Quinine : Ferr., 
Ipec, Nux v., Puis. 

Haemorrhage after Anger : Cha?n., Staph., (dur- 
ing pregnancy Kali carb.). 

Haemorrhage after Dancing or Walking, with or 
without pain : Crocus. 

Haemorrhage after a False Step, Lifting, or strain 
in loins : Cinnam., Croc, Rhus tox. 

Haemorrhage after Coition : Arnica. 

Haemorrhage after Every Stool : Iodine. 

Haemorrhage after Fright : Aeon., Bell., Nux. v. 
(during pregnancy Secale). 

Haemorrhage after Great Exertion : (mental, 
Plat.) Millef., Nux v. 

Haemorrhage after Labor (natural especially) : 
A?-n., Acetic ac, Bell., Bry., Cauloph., Cham., China, 
Croc, Erigeron, Ferr., Hamam., Hyosc, Ipec., Kali 
carb., Kreas., Lach., Millef., Nitr. ac, Nux v., 
Plat., Sabina, Secale, Senec, Trill., Ustilago. 

Haemorrhage after Labor, Days and Weeks : Kali 
carb. 



AN OBSTETRIC MENTOR. 143 

Haemorrhage after Labor, Difficult : Phos. 

Haemorrhage after Hasty Labors : Cauloph. 

Haemorrhage after Leucorrhcea : Magn. mur., 
.Sabina. 

Haemorrhage after Mental Excitement and De- 
pression : Ignat., Nux v. 

Haemorrhage after Motion (the least) : Crocus. 

Haemorrhage from Loss of Fluids : China. 

Haemorrhage from Overheating : Croc, Nitr. ac. 

Haemorrhage after Removal of the Placenta : 
Ipec. 

Haemorrhage from the Least Cause : Ambr., 
Sepia. 

Haemorrhage During Labor : Bell., Cham., China., 
Cinnam., Ferr., Hyosc, Ipec, Lye, Plat., Sabina, 
Secale. 

Haemorrhage During Pregnancy (without abort- 
ion) : Cocc, Phos., Plat., Rhus tox. 

Haemorrhage at Fifth and Seventh Month : 
Sepia. 

Haemorrhage at Third Month : Kali carb., 
Kreas., Sabina. 

Haemorrhage in First Month, from overheating, 
while cooking, etc.: Crocus. 

Haemorrhage from Uterine Atony, after Pro- 
tracted Labor : Secale. 

Haemorrhage from Uterine Atony and general 
debility : Cauloph., China. 

Haemorrhage from Constipation, high living, in- 
toxicants, etc.: Nux v. 

Haemorrhage while Nursing the Child : Silic. 

Haemorrhage from Retained Placenta or Coa- 
gula : Pulsat. 

Haemorrhage from Retained Placenta with De- 
lirium, loquacity, etc. : Secale, Stram. 



144 AN OBSTETRIC MENTOR. 

Haemorrhage from Retained Placenta ; profuse 
hot haemorrhage, speedily coagulating : Bell. 

Aconitum : Active haemorrhage with fear of 
death, moving, turning, or of something to happen. 
Vertigo. Can't sit up in bed or rise. Excitement. 
Plethoric, dark-hatred young women. 

Ac tea : Profuse dark coagulated flux with 
spasmodic heavy pressing down pains. Nerv- 
ousness, hysterical spasms, and chorceic motions. 
Rheumatic diathesis. 

> Alectris : Feeble women of lax fibre and anae- 
mia. 

Antimonium crud.: Uterine haemorrhage with 
distinct pressure in the womb, as if something would 
come out. White tongue : nausea and vomiting. 

Apis : Profuse flowing with heaviness in the ab- 
domen, faintness, uneasiness, yawning. Red spots 
like bee stings on the skin and stinging sensation in 
the ovarian region and elsewhere. 

Apocynum cann.: Uterine haemorrhage with 
great irritability of the stomach. Flux with large 
clots and shreds. Urinary and dropsical complica- 
tions. Fainting. 

Argent, nitr.: Confusion and pain in head, ag- 
gravated by the least movement. A short time 
seems very long to her : every thing done seems 
done so slowly. Belching wind relieves her dis- 
tresses. 

Arnica : After a full shock, or concussion, or 
fatigue. Constant bright red or clotted flux, with or 
without pain. Nausea at pit of stomach. Head hot 
and extremities cool. She feels sore as if bruised 
in the uterine region. 

Arsenicum : Lancinating burning pains : low 
states of the system when aphthae appear. 



AN OBSTETRIC MENTOR. I45 

Belladonna : profuse discharge of bright red 
hot blood with downward pressure, as if all 
would escape from the vulva and pain in the back 
as if it would break : blood coagulates easily and is 
sometimes offensive ; flowing between the after- 
pains. Hot red face and head, congested face and 
eyes and head. Worse from light, noise, motion, the 
least jar. Very frequently indicated after labor. 

Bryonia : Dark red hemorrhage with pain in the 
back and splitting headache. Dry mouth and lips ; 
thirst. Nausea and faintness on sitting up in bed, 
or even raising the head from the pillow. 

Calcarea carb.: Leucophlegmatic, plethoric 
women with light hair, who have usually menstruat- 
ed too often, too much and too long. Cold damp 
feet. Vertigo on stooping, worse when rising again 
or going upstairs. 

Cantharis : Uterine haemorrhage with great 
irritation of the neck of the bladder : cutting,, 
burning pains during the frequent efforts at mic- 
turition which only discharge a few drops. 

Carbo veg. : Passive haemorrhage : she is al- 
ready cold and deathly pale : excessive prostration 
and burning pain across the sacrum : itching of 
the vulva and anus. 

Caulophyllum : Uterine debility : profuse 
haemorrhage from a relaxed or feebly contracting 
womb after a hasty labor : passive oozing haemor- 
rhage. 

Chamomilla : Great irascibility or spiteful 
irritability. Flow dark, coagulated, black or foetid, 
lumpy, with frequent discharge of colorless urine,, 
tearing pains in legs and violent labor pains : flow- 
ing by fits and starts at irregular intervals. 

China : Haemorrhage, from uterine atony, and 



146 AN OBSTETRIC MENTOR. 

from abuse of Chamomile. Dark clots. Uterine 
spasms. Desperate cases after loss of vital fluids : 
skin cold and blue, twitching of muscles, heaviness 
in head and ringing in ears, vertigo, sight lost, 
fainting, pulse gone : China will sometimes save 
even such. 

Cinnamonum : Bright red flow after a misstep, 
strain in the loins, or some other exertion. (Com- 
pare Arm, Croc, and Rhus tox.) 

Crocus : Dark, stringy haemorrhage in dark or 
black strings after walking or dancing, with or with- 
out pain. Sensation of rolling and bounding in the 
abdomen. Very often the remedy in post-partum 
haemorrhage. 

Erigeron : Profuse bright red haemorrhage, 
alarmingly increased by every movement, with irri- 
tation of the bladder and rectum. 

Ferrum : Haemorrhage with fiery red face and 
hard full pulse. Flow partly fluid and partly black 
clotted, with violent labor-like pains, headache, 
vertigo, constipation, hot urine, and great weak- 
ness. 

Hamamelis : Passive haemorrhage with anaemia ; 
steady, slow, dark, painless flow. 

Hyoscyamus : Haemorrhage with general spasms 
of the whole body, interrupted by jerks or twitch- 
ing of single limbs. Bright red continuous flowing. 
Delirium, or even mania. 

Ignatia : Haemorrhage from abuse of Chamo- 
mile : great despondency, sighing, sobbing, etc. 

Iodine : Haemorrhage with every stool, cutting 
in abdomen, and pains in loins and small of back. 

Ipecacuanha : Constant, profuse bright red 
flow, or flowing in gushes ; with incessant nausea 
and vomiting, and cutting pain about the umbilicus. 



AN OBSTETRIC MENTOR. 147 

She is cold and pale, faint, gasping for breath. 
Haemorrhages after the abuse of Cinchona. One 
of our best helpers after expulsion of the child or 
removal of placenta. 

Kali Carb. : Haemorrhage with stitching pains. 
•Guernsey says : " One of the best remedies for post- 
partum haemorrhages." 

Lachesis : Paroxysms of pain in right ovarian 
region, relieved by a gush of blood. 

Lycopodium : Profuse, protracted flowing, partly 
black, clotted, partly bright red or serum, with 
labor-like pains until she faints. 

Millefolium : Profuse, sudden, bright red 
fluid. Haemorrhage after great exertion, especially 
in women phthisical or subject to haemoptysis. 
Lilienthal advises "in alternation with China." 
A very valuable remedy, to be studied with Bell., 
Cinnamon., Ipec, Sabina and Trillium. 

Nitric acid : Haemorrhage with violent pressure, 
as if everything were coming out at the vulva, with 
pain in small of back, through the hips and down 
the thighs. 

Nux mosch. : Dark, thick, long continued hemor- 
rhage (especially after abortion), with dry mouth 
and tongue, fainting, sleeplessness and hysterical 
symptoms. 

Nux vomica : Haemorrhage with large, difficult 
stools, or frequent call to stool with small, painful 
stools or without result. 

Phosphorus : Haemorrhage after difficult labor, 
in tall, slim, phthisical women with black hair. 
Constipation. 

Platina : Haemorrhage of dark, thick blood, 
with pain in back extending into both groins, and 
■excessive sensibilities of the genitals. Black clots or 



14^ AN OBSTETRIC MENTOR. 

fluids, or one thick, black, tarry mass. Sensation 
(with flowing) as if the body were growing larger in 
every direction. 

Pulsatilla : Intermittent black haemorrhage 
with clots, alternating with labor pains. Mild, 
gentle, weeping women, who want the doors and 
windows open so as to have plenty of fresh air. 

Rhus tox. : Haemorrhage after a strain or 
wrench, in rheumatic subjects. 

Sabina : Dark red haemorrhage, with dark clots 
in thin watery blood. Lilienthal says "most fre- 
quently bright red." Painless dark haemorrhage 
after delivery. Forcing down pain from sacrum to- 
pubes. The least movement increases the flow, but 
walking diminishes it. " Sabina is used next in 
frequency to Ipecac." (Guernsey). 

Secale : * Passive haemorrhage of dark, foetid, 
thin blood, in feeble cachectic women, who have 
borne many children ; with strong very painful 
bearing down pains (after pains). Desire for air, 
does not want to be covered although the body is- 
cold. Haemorrhage from uterine atony especially 
after protracted labor. 

Sepia : Plethora, or congestion with a sensation 
of weight. Pain in right groin ; fine darting pains 
in neck of uterus from below upwards ; feels better 
from drawing up the limbs. Yellow spots on face. 
Icy cold paroxysms, and flushes of heat ; cold feet. 
Painful "goneness" at pit of stomach. Urine foetid 
and has sediment as if clay were burned on bottom 
of the vessel. Constipation. 

Stramonium : Threatened puerperal fever ; de- 
lirium (with haemorrhage), excessive loquacity, 

* We have repeatedly verified these indications with Secale 
low. 



AN OBSTETRIC MENTOR. 149 

singing and praying. Full of strange absurd ideas. 
Thinks she sees rats, mice, vermin, snakes, etc., 
and looks under the bed for them. Drawing pains 
in. the limbs. 

Sulphur : Chronic haemorrhage ; she seems 
almost well and is then worse ; so on for days and 
weeks. Weakness, fainting, unseasonable hunger, 
flushes of heat ; heat on top of the head ; cold 
feet, etc. 

Sulphur, acid : Tremulous sensation all over 
without trembling, with passive haemorrhage. 

Trillium : Active haemorrhage of thick, dark, 
dotted blood (or rarely bright red flowing), after 
confinement or abortion. Great prostration. Women 
who habitually flow profusely after parturition. A 
very frequently useful remedy. 

Ustilago : Chronic passive haemorrhages. Slow 
persistent oozing of dark blood, with small black 
clots ; dark semi-fluid but not watery blood. Uter- 
ine inertia. 

Haemorrhages, whether before or after delivery, 
often tax the courage and skill of the attendant to 
the utmost ; but a calm, common sense treatment 
of each case, and a resolute dependence upon the 
similimum, will carry patient and doctor safely 
through what might be a most alarming experience 
should the accoucheur allow himself to be stam- 
peded. We have never lost a case from such a 
cause after several hundred confinements, although 
we have been witnesses of terrific and terrifying 
haemorrhages arrested by the indicated remedy in 
various potencies. In a desperate and apparently 
uncontrollable flooding, however, we should use 
hot water and plenty of it in a continuous stream 
against the os uteri. Where vital forces have 



150 AN OBSTETRIC MENTOR. 

seemed exhausted we have used stimulants until 
the remedy (often China or Carbo veg.) could effect 
reaction. Several women, faint, pale, cold, pulse- 
less, breathless and all but lifeless, we have seen 
revive after bathing the face freely with brandy and 
placing a drop or two upon the tongue. But this 
■ is purely temporary : do not depend upon stimu- 
lants long or you will lose your case. 



CHAPTER VIII. 

Fainting and Exhaustion. Puerperal Con- 
vulsions. 

Fainting During or After Labor, i. Aeon., Arn. r 
Ars., Carbo. veg., Cham., China, Coif., Digit., Nux 
v., Ign., Sep., Stram., Verat. alb. 2. Bry., Camph,, 
Cocc., Ign., Lach., Rhus tox. 

Aconite : Violent palpitation of the heart. Con- 
gestion of the blood to the head ; buzzing in the 
ears ; pale face on raising up : after a fright. 

Arnica : From injuries, fatigue or stitches about 
the heart. Head hot and body cool. 

Arsenicum : Debility or prostration when the 
least effort causes fainting : thirst for frequent sips 
of cold water : wishes to be wrapped up warmly ; 
pale bloating of face. 

Bryonia : Fainting fits from the least motion, 
even when no effort is required : sighing respira- 
tion : thirst for cold water in large quantities. 

Camphor : Marble-like coldness in the whole 
body : very weak pulse. Some prefer the mono- 
bromide, where nervous symptoms predominate. 

Carbo veg. : Fainting from weakness, caused by 
loss of animal fluids ; after sleeping ; after rising in 
the morning ; much belching of wind or eructation. 
Flatulent gastric dyspepsia. 

Chamomilla : Spiteful irritability ; very sensitive 
to the pains, which cause fainting with vertigo, 



152 AN OBSTETRIC MENTOR. 

dimness of vision, dulness of hearing and nausea ; 
must have fresh air and water. 

China : After loss of blood particularly, or 
other animal fluids : ringing in the ears, cold skin, 
loss of pulse, and cold sweat. 

Cocculus : Paralyzed feeling in the limbs with 
trembling ; paralytic weakness, particularly in the 
lower extremities ; spasmodic pains in the uterus, 
with nausea and vomiting. 

Coffee : Highly sensitive persons, after a fright, 
if Aconite fails. 

Digitalis : Pulse very slow, thin and irregular, 
cold sweat and death-like countenance. 

Ignatia : From grief ; much trembling, sighing 
and sobbing. 

Lachesis : Great and almost unconquerable sad- 
ness and gloom ; dreads society and company ; 
great and persistent constipation with sensation as 
if the anus were closed. 

Nux vomica : After indulgences at table ; after 
vomiting, after stool, after every labor pain ; with 
congestion of the blood to the head or chest, with 
trembling. 

Rhus tox.: Retention of urine ; a full bladder 
but no uneasiness or desire to urinate ; restlessness, 
especially after midnight ; left sided complaints. 

Sepia : Feet and hands very cold ; flushes of 
heat ; a distressed empty feeling in pit of stomach. 

Stramonium : Fainting spells every day several 
times a day ; she suddenly falls with pale face and 
almost imperceptible breathing ; face bloated ; very 
long continued faints. 

Veratrum alb.: Fainting from the slightest ex- 
ertion; turning in bed; straining at stool; retching as 
if to vomit,*etc.; cold sweat on forehead. 



AN OBSTETRIC MENTOR. 153 

For exhaustion compare : Ars., Cocc, Carb., 
China, Ferr., Iod., Kali carb., Lye,, Mur. ac, Nux 
v., Rhus tox., Sepia, Stram., Sulph., Verat. alb. 

Arsenicum : A sense of great exhaustion after 
every effort however small ; chilly, wants to be 
warmly wrapped up ; cold water is craved but dis- 
agrees ; very pale skin ; may be bloated ; great 
restlessness after midnight. 

Calcarea carb.: Leuco-phlegmatic women; 
much perspiration about the head and upper part 
of body ; every exertion is fatiguing ; going upstairs 
causes vertigo ; cold, damp, clammy feet ; the least 
cold air is unendurable. 

China : After haemorrhage or other loss of ani- 
mal fluids ; compare China, preceding section. 

Ferrum : Frequent attacks of tremor, alternat- 
ing wjth a sensation of weakness as if very weary ; 
trembling of the whole body ; feeling very weak, 
even from talking ; wishes to lie down, face and 
lips very pale, or cheeks fiery red. 

Iodine : Pulsation in all the arteries at every 
muscular effort ; great prostration of strength, so 
that even talking causes perspiration ; the sensibil- 
ity of the nervous system is greatly increased. 

Kali carb.: She feels the pulsation of all the 
arteries even down to her toes ; feeling of empti- 
ness in the whole body as if it were hollow ; the 
whole body feels heavy and broken down, so that 
it is only by the greatest effort she can make any 
exertion. 

Lycopodium : While lying in bed she feels as if 
she would die from weakness ; the lower jaw drops, 
not being able to keep the mouth shut ; slow 
breathing through the mouth ; eyes half open ; 
when walking she is obliged to let her hands hang 



154 AN OBSTETRIC MENTOR. 

down and the bones of her lower extremities are 
painful ; sudden weakness even while sitting ; red 
sand in urine ; intestinal flatulence (Carbo v. gastric 
flatulence). 

Muriatic acid : Great debility with haemor- 
rhoids, so painful that they can hardly be touched 
and often bleed ; so weak that she cannot keep up 
on a pillow but constantly slides down in the bed. 
Nux vomica : Debility from abuse of coffee, 
wines, spirituous liquors, or narcotics, or highly 
seasoned food ; night watching ; cannot walk on 
account of giving out of the lower extremities ; 
knees knock together ; wants to lie down all the time ; 
cannot sleep after three o'clock in the morning ; great 
sensitiveness to external impressions, noise, talking, 
strong scents and odors, or bright light ; blue 
margin around the eyes ; nose looks more pointed 
and sharp than usual ; face shrunken. 

Rhus tox. : Restlessness relieved for a short 
time by change of position ; loss of appetite ; cold 
water disagrees ; compare Rhus, preceding section. 

Sepia : Urine deposits a very hard crusty sedi- 
ment ; anorexia ; compare Sepia, preceding section. 
Stannum : Great weakness in larynx and chest, 
thence all over the body, from talking or reading 
aloud ; worse after twelve o'clock, noon. 

Sulphur : Frequent weak faint spells, especially 
from eleven to twelve every morning; flushes of 
heat, cold feet ; heat on top of head. 

Veratrum alb.: Excessive weakness : is obliged 
to move very slowly : she can hardly raise her 
hand and every motion seems to increase the debil- 
ity ; weak almost imperceptible pulse and thirst for 
icy cold water ; compare Veratrum, preceding 
section. 



an obstetric mentor. 155 

Puerperal Convulsions. 

1. Aeon., Actea, Bell., Cupr., Gels., Hydroc. ac, 
Hyosc.^ Stram., Verat. virid. 

2. Arg. nitr., Arn., Bry., Canth., Cauloph., 
Caust., Cham., China, Cicuta, Cocc, Coff., Glon., 
Hell., Hydroph., Ign., Ipec., Kali brom., Kali 
carb., Lach., Merc, s., Nux mosch., Nux v., 
Opium, Phos., Puis., Secale, Tanac., Verat. alb., 
Zinc. 

Aconite : Hot dry skin, thirst, restlessness, fear 
of death, cerebral congestion ; pri?niparoz with fore- 
going symptoms and spasmodically contracted (or 
perhaps rigid) os uteri. 

Actea : The spasms are preceded by great 
mental excitement, with visions of objects not pres- 
ent, and are followed by languor, and relaxation of 
the whole system. The paroxysms are very violent. 
Convulsions with spasmodically contracted (or rigid) 
os uteri. 

Belladonna : She appears as if stunned ; semi- 
consciousness and loss of speech ; convulsive move- 
ment of the limbs and muscles of the face ; 
paralysis of the right side of the tongue ; difficult 
deglutition, foam at the mouth ; dilated pupils, red 
or livid countenance : she may have a pale and 
cold face with shivering ; fixed or convulsive eyes ; 
involuntary escape of urine or faeces. Renewal of 
spasms with every pain ; unconsciousness or more 
or less tossing between the spasms ; or deep sleep 
with grimaces, starts, cries and fearful visions ; 
violent pulsations of the carotids ; jerking and 
twitching of muscles between the spasms. Bell. 
is the chief remedy and always first to be considered 
in puerperal convulsions. 



156 AN OBSTETRIC MENTOR. 

Cuprum met. : Spasms with or preceded by vio- 
lent vomiting j opisthotonos with every paroxysm, 
with spreading out of the limbs and opening of 
the mouth. The spasms begin as cramps in the 
fingers and toes, or in the whole extremities ; or 
even in the abdomen. 

Gelsemium : Head feels large, or she has a 
stupefying occipito-frontal headache, with great 
muscular prostration. She feels and looks stupid, 
face dark red, speech thick, pulse slow and full, 
symptoms premonitory of convulsions ; albumin- 
uria ; rigid os uteri with convulsions or preceding 
them. Compare. This drug probably ranks next 
to Belladonna in frequency of value. 

Hydrocyanic acid : She is conscious of a shock 
passing through her whole body before the spasm. 
(Compare Helleb.) 

Hyoscyamus : Bluish face and twitching and 
jactitation of every muscle of the body, face, eyelids 
and all. Shrieks, anguish, oppression of the chest, 
continued delirium or unconsciousness. 

Stramonium : She appears terrified and shrinks 
back from every object on opening her eyes ; or 
she looks under the bed for vermin a?id reptiles 
which she fancies are there. Sardonic grin ; stam- 
mering or loss of speech. Puffed up red face ; 
loss of consciousness and sensibility ; cries and 
frightful visions ; laughter, singing, efforts to escape; 
copious perspiration with the spasms, which are 
caused or renewed by the sight of bright objects 
and sometimes by contact. 

Veratrum viride : Full, hard, quick pulse is 
characteristic of this drug ; cold clammy sweat ; 
convulsions before, during and after labor, es- 
pecially where mania remains after the con- 



AN OBSTETRIC MENTOR. 157 

vulsions cease. Furious delirium. Emotional 
causes. 

Compare also secondly : 

Argentum nitricum : She has a presentiment 
of the coming spasm (an aura epileptica ?) She 
is in constant motion from the time she comes out 
of one spasm until she goes into another. The 
spasms are violent and preceded by a sensation of 
expansion of the whole body, but especially of the 
face and head. 

Arnica : Full strong pulse and during every 
pain the blood rushes to the head and face ; symp- 
toms of paralysis of left side (Bell, right) ; loss of 
consciousness ; involuntary stool and urine ; head 
hot and body cool. Abdominal tympanitis after 
labor. 

Bryonia : After the spasms cease there is full 
hard pulse, thirst, abdominal tenderness, perspira- 
tion, and dry parched lips ; she cannot bear to 
move or be moved. 

Cantharis : Bright light on objects, and the 
sight, sound or use of water causes violent spasms ; 
dysuria. 

Caulophyllum : Spasms during labor, with very 
moist genitals and spasmodically contracted os uteri. 

Causticum : Spasms with screams, gnashing of 
the teeth and violent movements of the limbs. 

Chamomilla : Spasms excited by. anger ; one 
red and one pale cheek. Starts and shocks during 
sleep. Great impatience and disposition to anger. 

China : Spasms caused by great loss of blood. 

Cicuta : Strange contortions of the body and 
limbs during the paroxysms, with blue face and 
frequent interruptions of breathing for a few mo- 
ments. 



158 AN OBSTETRIC MENTOR. 

Cocculus : Spasms following difficult labor, and 
those developed by changing the patient's position. 

Coffea : Extreme excitability of the nervous sys- 
tem and sleeplessness. Spasms, with cold extremities 
and grinding of the teeth. 

Glonoine : Spasms, unconsciousness ; face 
bright red, puffed up ; pulse full and hard ; urine 
copious and albuminurious ; after protracted and 
difficult labor. 

Helleborus : A shock passes through the brain 
as if by electricity, followed by spasms. 

Hydrophobin : Spasms excited whenever she 
attempts to drink water, sees it, or hears it in motion 
(also Canth.), even though she desires it. 

Ignatia : Deep sighing and sobbing, with a 
strange compressed sensation in the brain. The 
spasms commence and terminate with groaning and 
stretching of the limbs. Fright with grief the ex- 
citing cause. 

Ipecacuanha : Incessant nausea with occasional 
spasms. 

Kali bromatum : Advised by Hempel, Hart 
and others in material doses. 

Kali carbonica : Spasms relieved or passing 
off by frequent eructations. 

Lachesis : Convulsions particularly violent in 
the lower extremities, with cold feet, stretching 
backward of the body and crying out. 

Mercurius sol. : Much salivation and driveling ; 
convulsions, mostly in the extremities. 

Nux moschata : Convulsive motion of the head 
from behind forward. Hysterical women who faint 
easily ; drowsy before and after the spasms. 

Nux vomica : Great torpor of intestinal canal ; 
irritable disposition, etc. 



AN OBSTETRIC MENTOR. 159 

Opium : Sopor with stertorous respiration, which 
continues from one spasm to another. Incoherent 
wandering and convulsive rigidity of the body, 
with red, swollen, hot face. Hot perspiration and 
insensible pupils. Suppressed labor pains : Opium 
is one of the chief of the lesser remedies. 

Phosphorus : Previous to the convulsion a sensa- 
tion of heat rushes up the back into the head. 

Pulsatilla : Face cold, pale and clammy. 
Loss of consciousness and motion ; stertorous 
breathing and full pulse. Labor pains deficient, 
irregular and sluggish. Mild and tearful and wants 
doors and windows open to get fresh air. After 
labor. 

Sec ale : Scrawny, illy nourished women with 
too feeble labor pains ; violent forcing after pains ; 
opisthotonos. 

Tanacetum vulgare : When taken to produce 
abortion often causes convulsions. 

Veratrum album.: Pallor, collapse, anaemic or 
violent cerebral congestion with bluish bloated face ; 
delirium, wild shrieks and tearing of the clothing. 

Zincum met.: Eruptions have recently disap- 
peared, even old eruptions ; muscular twitchings ; 
coma, from cerebral exhaustion, loss of sensation. 
After failure of the indicated Phosphorus. 

Puerperal convulsions have been divided into 
various kinds upon various principles ; but as these 
distinctions are purely theoretical, sometimes con- 
fusing, and not always based upon scientific facts, 
we have ignored them. Do not neglect to see that 
the bladder and rectum are unloaded and if the 
woman be " at term " the progress of the labor 
should be assisted by all means at command, even 
to the use of instruments if the head descends 



^m 



l6o AN OBSTETRIC MENTOR. 

slowly. But if the time of pregnancy has not ex- 
pired, avoid all tampering with the uterus until 
certain that therapeutic means will fail to save the 
maternal life, as all such interference tends to in- 
crease the irritation we seek to allay. Above all let 
peace and calm quiet endeavor prevail ; no confu- 
sion in the furniture, action and conversation of 
the attendants ; let these latter be few and their 
talk little. 

Many authorities advise anaesthetics, and some 
chloral and bromides in material doses. Richardson 
mentions morphia and atropine in combination 
one-eighth to one-ninety-sixth of a grain. 



CHAPTER IX. 

Retained Placenta. Retention of Urine. 
After Pains. Lochia. Abdominal Soreness. 
Umbilical Ulceration. Pendulous Abdo- 
men. Constipation and Diarrhoza. 

* For retained placenta : First Pulsatilla is 
more frequently indicated and generally useful than 
all others. Uterine inertia, or spasmodic reten- 
tion ; intermittent flow of blood ; restlessness ; she 
wants the fresh air admitted and weeps because the 
labor is not completed. 

Also: i. Bell., Canth., Sabina. 

2. Actea, Cauloph., Gels,, Gossip., Sec, Sepia. 

Belladonna : Red face and eyes, great distress 
and moaning : great heat and dryness of the vagina ; 
profuse flow of hot blood, which speedily coagu- 
lates : the slightest jar of the bed causes great 
suffering. 

Canth aris : Burning pain in the pelvis and back; 
fever, vomiting, great anguish and distress ; swell-, 
ing of the lips of the os uteri. 

Sabina : Intense after pains, notwithstanding the 
retained placenta, with discharge of fluid blood and 
clots in equal parts with every pain. Pain, or un- 
easy bad feeling from sacrum and pubes and a 
slight sensation as of motion in the abdomen. 

* Compare Hour-glass Contractions, page 182. 



162 AN OBSTETRIC MENTOR. 

Finally compare : 

Actea : Rheumatic women ; distressing tearing 
pain in uterine region ; no uterine action. 

Caulophyllum : Spasmodic retention. 

Gelsemium : Retained placenta with cutting 
pains in the lower abdomen running upward and 
upward and backward. 

Gossipium : Retained placenta, especially after 
abortion or premature labor. 

Sec ale : Constant sensation of bearing down ; it 
seems (to her) too constant and strong to be effect- 
ual ; passive haemorrhage ; the parts seem relaxed 
and there is an absence of uterine action. 

Sepia : Little sharp shooting pains in the cervix 
uteri, sometimes with burning. 

If the uterus is followed down and contracted by 
a hand, steadily, gently and firmly pressing down 
and back during the second stage of labor, retained 
placentae are rare. Nor do we believe that such 
cases should be left to nature and the indicated 
remedy indefinitely ; when the placenta is not re- 
pelled under influence of the indicated remedy within 
an hour or so remove it by hand. We practice and 
advise Crede's Method of expressing the placenta. 

For retention of urine (after delivery) : 

i. Ars., Caust., Hyosc. 

2. Arn., Bell., Canth., Lye, Nux v., Puis., 
Secale, Sepia, Stram., Sulph. 

Arsenicum : No sensation as of desire to urinate, 
or inconvenience from a long retention : we rely 
upon this drug and rarely have to employ any 
other. 

Causticum : Retention of urine with frequent 
and urgent tenesmus ; occasionally a few drops 
pass involuntarily. 



AN OBSTETRIC MENTOR. 163 

Hyoscyamus : Retention of urine with constant 
pressure in the bladder. 

Also : 

Arnica : Retention with urging to urinate and a 
bruised sore feeling. 

Belladonna : The urine only passed in drops, 
without pain. 

* Cantharis : Great desire to urinate, with cut- 
ting burning pains in the bladder or urethra. Com- 
plete retention or very painful drippling of urine. 
The remedy for painful retention next to Caust. 

Lycopodium : Retention of urine with violent 
pain in the back, coming on in paroxysms ; when 
she can urinate the back is better, but when the 
flow of urine is checked the backache is worse. 

Nux vomica : Painful and ineffectual desire to 
urinate : frequent urging to stool: where Canth. 
seems indicated and fails, Nux is often successful. 

Pulsatilla : Retention of urine with heat, red- 
ness and soreness of the hypogastrium externally, 
which is painful to the touch. 

Secale : Dr. Marsden recommends this drug in 
10 drop doses of the mother tincture for retention 
of urine after confinement. It is more applicable 
to suppression than to retention. 

Stramonium : Retention (or more probably sup- 
pression) of urine with a sensation as if the urethra 
were too narrow. Although she strains violently 
only a few drops are passed (because the bladder is 

* There has been a tendency of late years to discard Canth., 
and use Apis in its stead, a very grave error. Apis and Stram. 
correspond to suppression of urine and their action refers to 
the kidney more than the bladder ; while Cantharides pi-oduces 
(and cures) retention of the already secreted urine, and rarely 
profoundly affects the kidney. 



i™ 



164 AN OBSTETRIC MENTOR. 

empty). Or, she passes no urine and suffers no 
painful sensation. 

Sepia and Sulphur : Chronic retention of urine 
after confinement. 

We cannot endorse the advice given by at least 
two homoeopathic accoucheurs, that the catheter 
should be used without any drug trial whatever in 
every case of retention of urine. We never drew 
water but for two women after labor, and one had 
been delivered by another physician with inconceiv- 
able brutality after a long labor, marked by colossal 
blunders. 

For After Pains. 

1. Am., Cauloph., Cham., Morph. acet., Secale, 
Viburn. 

2. Actea, Bell., Bry., Coff. } Cupr. acet, Cupr. ars. y 
Ferr., Gels., Hyosc, Ign., Kali carb., Nux ?;., Puis., 
Rhustox., Sabina, Sepia, Sulph., Sulph. ac, Xanthox. 

* Arnica : If this drug is given promptly after 
the close of labor, after pains may often be entirely 
averted, or at least held in check. 

Caulophyllum : Spasmodic pains in the lower 
abdomen, sometimes extending into the groins ; 
after protracted and exhausting labors particularly. 

Chamomilla : Very distressing after pains, she 
feels that she cannot bear them. She wishes to 
get away from herself and is ill-natured and irrita- 
ble. Dark lochia. Thirst. Desire for fresh air. 
One of our best remedies for this condition. 

Morphia acet. : This drug is highly recom- 
mended in the 2X trituration by Dr. Marsden. 
We have used it empirically many times with fewer 

* We have frequently had women to whom Arnica was given 
after labor say to us, " Every time I take that medicine it 
seems to stop the after pains for a while." 



AN OBSTETRIC MENTOR. 165 

failures than with any drugs excepting Chamomilla 
and Viburnum. 

Secalk : Thin, scrawny, elderly women who 
have borne many children. A prolonged, pressing, 
forcing, labor-like pain, frequently repeated. Thin 
brown lochia. Although she feels cold she does 
not want to be covered. 

Viburnum opulus : Violent cramp-like after 
pains. Hysterical nervous women. 

Also : 

Actea : Low-spirited, sleepless, restless women, 
very sensitive to impressions and feels her pains 
very keenly : (Compare Cham.) 

Belladonna : Pains come on and go off very 
suddenly and are severely forcing, as if the contents 
of the pelvis would be forced through the vulva. 
She cannot endure noise, light, or a jar of the bed. 
She complains that the lochia is hot. 

Bryonia : After pains excited by the least mo- 
tion, even by taking a deep inspiration ; she wants 
to lie perfectly quiet. Splitting headache. Dry 
lips and mouth and throat. 

Coffea : Sleeplessness. Very distressing pains 
which she feels acutely. 

Cuprum acet. : Terrible cramping pains which 
often produce cramps of the extremities, including 
the fingers and toes. 

Cuprum ars. : This drug is highly recom- 
mended by Dr. Marsden ; it seems to resemble 
Cupr. acet. and Viburnum. 

Ferrum : Violent labor-like pains in the loins 
and abdomen, with discharge of partly fluid and 
partly clotted blood ; full hard pulse ; frequent 
short shuddering headache and vertigo. Feeble 
women with fiery red faces. 



l66 AN OBSTETRIC MENTOR. 

Gelsemium : Severe pains running upward and 
backward ; she seems to have lost control of her 
muscular movements. 

Hyoscyamus : Much jerking and twitching 
of various parts of the body ; she is delirious. The 
pains are spasmodic. 

Ignatia : Much sighing, sadness and despond- 
ency with after pains. 

Kali carb. : Stitching, shooting pains. Pains 
in the back shooting down into the gluteal region 
or hips. 

Nux vomica : Aching pains. Every pain pro- 
duces desire to go to stool ; or sensation in the 
rectum as of something there to be evacuated. 
Sore feeling in the uterine region, so that she dreads 
to be moved or disturbed in any way. Irritability. 
Desire to have the room warm and to be well 
covered. 

Pulsatilla : Mild, tearful disposition. The 
pains become worse toward evening. Thirstlessness. 
Bad taste in the mouth. She feels uncomfortable if 
the room is moderately warm and wants the doors 
and windows open and plenty of fresh air. Rest- 
lessness. Changeable feeling, now better now 
worse. 

Rhus tox. : Pains worse at night with great 
restlessness ; they last sometimes all night and 
there is not much pain during the day. Frequent 
change of position gives temporary relief. Likes a 
warm room and covering. 

Sabina : Pains from sacrum to pubes. With 
every pain discharge of fluid and clotted blood. 
Pains sometimes from back and sacrum to thighs. 

Sepia : Constant sensation of weight in the 
anus ; pain shooting upward in the vagina. Pains 



AN OBSTETRIC MENTOR. 167 

felt mostly in her back ; severe forcing or bearing 
down occurring in paroxysms in the back. 

Sulphur : Lochia scanty. She feels badly in 
the abdomen although the pains are in the uterine 
region exclusively. Bleeding, itching, sore haemor- 
rhoids. Flashes of heat ; weak faint spells. Soles 
of feet either cold or burning hot. 

Sulphuric acid : Great general weakness. 
Sense of trembling all over without actual trem- 
bling. 

Xanthoxylum : This drug is warmly recom- 
mended for after pains by Prof. O. B. Gause and 
others. Spare habit, nervous temperament and 
delicate organization seem more particularly to call 
for this drug. 

Variation of the Lochia. 

Lochia, Acrid : Bapt., Carbol. ac. 

Lochia, Acrid, Watery : Con. 

Lochia, Aggravated by the least jar : Bell. 

Lochia, Aggravated by the least Motion : Bry. 

Lochia, Reproduced by Motion and Relieved by 
Rest : Eriger. 

Lochia, Aggravated by Eating and Drinking : 
Colocynth. • 

Lochia, Aggravated by a Warm Room : Puis. 

Lochia, aggravated when Child nurses : Ferr., 
Phelland., Silic. 

Lochia, Aggravated at night with Inflammation 
of the genitals : Merc. s. 

Lochia, Black, (Clotted) : Bell., Kreas., Plat., 
Crocus. 

Lochia, Brown : Carbo. veg., Secale. 

Lochia, Cadaverous : Stram. 

Lochia, Cheesy : China. 



l68 AN OBSTETRIC MENTOR. 

Lochia, Corroding : Bell., Carbo. an., Kreas., 
Lilium, Sepia, Sil. 

Lochia, Causing Debility : Rhus tox., Sulph. 
ac, Trill. 

Lochia, Dark : Cham., Secale. 

Lochia, Dark and Stringy : Crocus. (Pus-like 
or mucous strings) Kali b. 

Lochia, Foetid : Bapt., Carbol. ac, China, Lach., 
Secale, Sepia. 

Lochia, Hot : Bell. 

Lochia, Ichorous : Rhus tox. 

Lochia, Intermittent : Kreas., Plat. 

Lochia, Milk-like : Calc. carb., Puis. 

Lochia, Offensive : Aeon., Bell., Carb. an., 
Carbo. veg., Kreas., Nux v., Rhus tox., Secale, 
Sepia. 

Lochia, Pale at first, then bloody : Calc. carb. 

Lochia, Profuse : Aeon., Bry., Carbol. ac, China, 
Corf., Con., Eriger., Hep., Millef., Plat., Rhus' tox. 
Secale, Trill., Ustil. 

Lochia, Profuse and Too Long : Asar., Bry. 
Calc. carb., Croc, Eriger., Hep., Plat., Puis 
Rhus tox., Secale, Senec, Trill., Ustil. 

Lochia, Profuse, Too Long and Corrosive : 
Lilium. 

Lochia, Profuse, In gushes : Plat. 

Lochia, Too Long : Aur. met., Carb. an., China, 
Merc, s., Nux mos., Rhus tox. 

Lochia, Too long : Thin, offensive, excoriating : 
Bell. 

Lochia, Too Long in habitually profuse menstrua- 
tors : Calc. carb. 

Lochia, Too Long, oozing passively : Cauloph., 
Ustil. 

Lochia, Too Long, Bloody : Cauloph. 



AN OBSTETRIC MENTOR. 169 

Lochia, Purulent : Calc. carb., China, Merc, s., 
Sepia. 

Lochia, Red : Calc. carb., Cauloph., (Bry. bright. 
Aeon. deep). 

Lochia, Scanty : Aeon., Secale, Strain., Sulph. 

Lochia, Scanty and Offensive in high livers : 
Nux v. 

Lochia, Scanty and Milky : Puis. 

Lochia, Scanty, Too Long, black and clotted : 
Plat. 

Lochia, Suppressed : Aeon., Aetea, Alect., Ars., 
Bapt, Bell., Cauloph., China, Coloeynth, Hedeoma, 
Hyosc., Millef., Nux v., Plat., Puis., Secale, Stram., 
Tereb., Verat. alb., Verat. virid., Zinc. 

Lochia, Suppressed, followed by diarrhoea, colic, 
toothache, etc.: Cham. 

Lochia, Suppressed from anger : Coloeynth. 

Lochia, Suppressed, from cold (and damp, Dulc): 
Aeon., Actea, Verat. virid. 

Lochia, Suppressed, from fright (or grief, Ignat.): 
Opium. 

Lochia, Suppressed, with child-bed fever (or 
threatened): Aeon., Secale, Stram., Verat. virid. 

Lochia, Suppressed, with spurious peritonitis : 
Verat. virid. 

Lochia, Suppressed, with splitting headache : 
Bry. 

Lochia, Suppressed, with colic, tympanites and 
diarrhoea : Coloeynth. 

Lochia, Ceasing almost, only to return and so 
alternates : Kreas. 

Lochia; Thin : Bell., Carbo. an., Lach., Rhus 
tox., Secale. 

Lochia, Viscid : Crocus. 

Lochia, White : Puis., Sepia, Sulph. 



170 AN OBSTETRIC MENTOR. 

Aconitum : Lochia, suppressed (or too scanty) 
with distress iu abdomen, chest, and head, from 
local congestion (compare Verat. virid). Fever, 
thirst, restlessness, fearfulness. Sharp cutting 
pains in the tender abdomen. 

Arsenicum : Offensive acrid watery lochia, with 
fever, prostration, restlessness, thirst and threaten- 
ing toxaemia. 

* Baptisia : Very offensive and acrid lochia with 
debility, prostration and delirium. 

Belladonna : Offensive hot lochia. Flushed 
face and injected eyeballs ; delirium and frightful 
visions. Pain in the uterine region coming and 
going suddenly. Drowsiness, or she is half awake 
and half asleep ; or she does not sleep sound and 
is not refreshed by her sleep. Very sensitive to even 
a jar of the bed ; great tenderness of the abdomen. 

Bryonia : Suppression of the lochia with sensa- 
tion as if the head would burst. The least motion 
aggravates her suffering. Dry mouth and lips. 
Profuse lochia with burning pains in uterine region. 
Thirst for large draughts at a time. 

Calcarea carb.: Lochia lasts too long in women 
who habitually menstruate too profusely ; milky 
lochia. 

Caulophyllum : Lochia lasts too long and is 
too long bloody, oozing passively from relaxed 
uterine vessels ; great exhaustion. 

f Chamomilla : Suppression of lochia followed 

* In threatening puerperal toxaemia or fever it may be dif- 
ficult to differentiate between Ars. and Bapt. As a generality 
it may be said, Ars. has more restlessness; while Bapt. has 
more delirium. 

f Both Chamomilla and Coffea are drugs more useful in and 
above the 30th dilution than in any lower potency. 



AN OBSTETRIC MENTOR. 171 

by colic, diarrhoea, and headache ; irritable and im- 
patient ; thirst ; redness of one cheek while the 
other is pale. 

Coffea : Profuse lochia with exalted nervous 
sensibility and great wakefulness. 

Colocynthus : Suppression of lochia with vio- 
lent colic, or from anger ; tympanitic abdomen and 
diarrhoea. Aggravation after eating and drinking ; 
great restlessness. 

Carbo animalis : Lochia too long ; thin, offens- 
ive, excoriating discharge with numbness of the 
limbs. 

Crocus : Lochial discharge in dark strings ; 
sensation of motion in the much distended ab- 
domen. 

Dulcamara : Lochia suppressed by cold or 
damp, and the milk greatly diminished. 

Erigeron : The least motion excites a return 
of the bloody lochia, which is relieved by rest. 

Hyoscyamus : Delirious jerking of the muscles. 
She says she is being drugged or poisoned, very 
suspicious. 

Ignatia : After abuse of Chamomile tea ; if 
produced by fright or grief with sighing and sob- 
bing. 

Kreasote : Very offensive, excoriating lochia. 
The discharge almost ceases, when it becomes much 
more profuse and again almost disappears and anon 
returns, etc. 

Merc, sol.: Discharge worse at night with some 
swelling and inflammation of the genitals. Groins 
sore and swollen. 

Nux vomica : Scanty and offensive lochia in 
women accustomed to high living. Frequent calls to 
stool and to urinate, with scalding urine ; soreness. 



172 AN OBSTETRIC MENTOR. 

in uterine region : she does not wish to move or be 
disturbed ; wants to be warm. 

Opium : Lochia suppressed from a fright, with 
sopor. 

Platina : A little black clotted discharge re- 
mains a long time ; genitals very tender ; she can- 
not endure the usual napkins ; intermittent dis- 
charge in gushes ; very changeable sensations ; can- 
not bear a warm room. 

Pulsatilla : The milk has suddenly dried up ; 
the lochia scanty and* milky ; feverish but no thirst. 

Rhus tox.: Lochia lasts too long and is thin and 
ichorous, and offensive as it becomes occasionally 
b>loody. She is well nigh exhausted ; shooting 
pains up the rectum ; restless at night, must change 
position often and finds relief by it. 

Secale : Offensive, thin, scanty or profuse very 
dark lochia in thin scrawny women, or those who 
have many children ; painless discharge or (more 
often) ; prolonged bearing dow7i pains, very severe 
and often recurring. 

Sepia : Foetid odor ; characteristic excoriating 
lochia with little sharp pains in the uterine neck ; 
distressing bearing down in the back. 

Silicea : Pure blood flows every time the child 
nurses ; after pains in the hips ; sometimes excori- 
ating discharge. 

Stramonium : Mind full of strange absurd but 
strongly marked ideas ; thinks she sees rats and 
mice under the bed and looks to find them ; lochia 
having a cadaverous odor. 

Sulphur : The discharge causes a sensation of 
weakness, and she has hot flushes ; perspiration ; 
heat of the soles of the feet (or her feet are cold all 
the time) ; sore bleeding itching piles. 



'; an obstetric mentor. 1 73 

Abdominal Soreness. 

For this distressing and sometimes alarming 
sequela of labor use Hamamelis internally and 
locally in hot water. 

Compare also : Arm, Colocynth., Con., Mur ac, 
Plumb., Rhus tox., Ruta, Sulph. 

* For Cracks on the Abdominal Surface : Hep., 
Sepia, Sil., Sulph. 

For Umbilical Ulceration : i. Ars. 2. Apis, 
Lach., Lye, Sep., Sil., Sulph. 

For Pendulous Abdomen : 1. Bell., Croc, Plat., 
Podoph., Sepia, Secale. 2. Calc. carb., China, Col- 
ocynth., Kali carb., Nux v., Viburn. op. 

Alvine Discharges. 

For treatment of the usual constipation or the 
more rare diarrhoea of lying-in women, compare 
what has been said under these headings in our first 
chapter, bearing the following in mind. 

For Constipation {after confinement) : 1. ALs- 
cul., Podoph., Phyt. 2. Nux v., Opium, Sulph. 

For Diarrhoea [after confinement) : 1. Hyosc, 
Rheum., Secale. 2. Ant. crud., Dulc, Phos. ac, 
Puis. 

* Compare same rubric, page. 



CHAPTER X. 

Puerperal Fever and Spurious Peritonitis. 

Puerperal Insanity, Milk Leg. 

Pelvic Cellulitis. 

For Puerperal Metritis : i. Aeon., Apis., Verat., 
vir. 2. Arn., Bell., (Calend. when extensive lacera- 
tions cause a primary inflammation) Iod., Merc, s., 
Puis., Nux v., Stram., Terebinth. 

Puerperal Peritonitis : i. Aeon., Apis, Cham., 
Coloc, Puis., Terebinth., Verat. vir. 2. Bell., Bry., 
Merc, s., Nux v., Rhus tox. 

Uterine Putrescence : 1. Bapt., Carbo. veg., 
Secale. 2. Ars., Carbol. ac, Kreas., Salicylic ac, 
Sulph., Ustil. 

Puerperal Typhoid : 1. Ars., Bapt., Bry., Chin, 
ars., Mur. ac, Phos. ac, Rhus tox., Terebinth. 2. 
Arn., Bell., China, Stram. 

Puerperal Ovaritis : 1. Apis, Bell., Lach., Merc 
sol., Podoph. 2. Con., Plat., Puis., Sabina. 

Partiadar Indications : 

Aconitum : General inflammatory action with 
shiverings, * rigors, chattering teeth, and tenderness 
of the whole abdomen ; followed by intense and 
continued heat, thirst, short breathing ; headaches 

* Dr. Eaton thinks Arsen. should be given during the rigors 
and Aeon, exhibited only when the reaction is established, as 
shown by fever, thirst, etc. 



AN OBSTETRIC MENTOR. 1 75 

all over, with swimming sensation, forcing her to 
turn to the right ; she feels as though the bed were 
turning around, and inclines to lie on the right side. 
She speaks and acts horridly, and is peevish, fretful, 
apprehensive, vigilant and anxious. Loathing of 
food, and the odor from it often nauseates her. 
Pulse hard and quick. Flying, stitching, sharp, cut- 
ting, burning pains here and there all over the bowels 
with occasional flatulency ; urinates often with shud- 
derings. Thin watery painful diarrhoea ; lochia 
suppressed, mammae lax and empty. Says Dr. O. 
P. Baehr, " Aco?iite cannot be too highly praised for 
puerperal fever where no appearance exists of 
mechanical injuries," and the above symptoms su- 
pervene. 

Apis : Restlessness from a fine rough, red, sting- 
ing rash ; breathing hurried and difficult, feeling 
as though she could not breathe ; excited and anx- 
ious ; wants to get up every few moments, and then 
drops back again ; is uneasy and fears death ; 
seems disposed to scold, but gets confused ; com- 
plains that she cannot collect her ideas ; head feels 
stupid ; dull stinging burning pain in the abdomen 
with rumbling and uneasy distention, accompanied 
by a feeling as of approaching diarrhoea ; bearing 
down feeling with heat and dry burning of vagina ; 
suppression of lochia. Downward pressure from the 
abdomen upon uterus and ovaries with moaning and 
muttering ; hysterical laughing and crying. 

Arnica : Particularly in primiparae who have 
suffered dystocia, bruises, retained placenta (or 
placental shreds), and have foul odorous lochia. 
Mostly cases from the first to fifth day. Severe 
chill throughout the whole body, hands and feet 
cold, head and face hot ; no thirst ; yawning and 



I 76 AN OBSTETRIC MENTOR? 

sleepless until after midnight, yawning and nausea 
and bruised feeling, itching and tingling down the 
back and lower limbs, with shiverings in streaks 
down the back and thighs, fever after a long chill, 
lasting until late in the evening, with sour sweats 
towards morning ; tongue rough and heavily coat- 
ed ; ropy saliva and sour breath ; frequent flushes 
of heat to chest and face, with anguish and oppress- 
ed breathing and abdominal soreness ; sudden starts 
in sleep as if frightened, sleep restless and full of 
dreams, waking up tired and tremulous ; dizzy on 
raising the head, flashes of heat from the uterus 
through the abdomen to the stomach, creating 
nausea and even vomiting. Abdomen tympanitic. 

Arsenicum alb.: Burning, throbbing, lancinat- 
ing pains in the abdomen. Great restlessness, want 
of sleep, anguish with fear of death, and sudden ex- 
treme prostration ; sunken countenance, sallow or 
livid complexion. Burning heat, and thirst ; dry 
parched lips ; vesicles on the lips and face ; nausea 
and vomiting, dizziness, headache, delirium ; small, 
feeble, intermittent pulse. Dr. Eaton recommends 
the iodide of arsenic. 

Baptisia : Puerperal fever or septicaemia from 
absorption of purulent matters, with typhoid symp- 
toms : foztid lochia, with much prostration. Abdo- 
men distended, fullness, flatulence, and rumbling ; 
feels as if vomiting would relieve ; sharp shooting 
pains in the bowels, urine scanty and dark red ; op- 
pressed breathing ; delirium. 

Belladonna : Fever marked by frequent alter- 
nations of chill, heat, and perspiration ; or fre- 
quently the patient will be chilly for some time 
over the chest, shoulders, back and limbs ; then 
hot ; then chilly again. Sharp, quick, electric- 



AN OBSTETRIC MENTOR. I 77 

like intermittent pains, bearing down with an invol- 
untary straining force ; she says, "I can't help it." 
Sensitive to light, noise, motion, jarring the bed or 
walking heavily disturbs her very much. Delirious, 
furious, nervously excited, mind wanders, urine and 
milk diminished ; urine passed involuntarily and 
offensive. After fright, mortification, chagrin, cold 
and hard labor. She draws up her limbs every few- 
moments to relieve the abdominal tension. Fleshy 
women, angular in their motions, language and 
thoughts. Abdomen distended. Headache and 
red face. Difficult deglutition. Sleeplessness. 
Lochia (suppressed) or scanty, watery, slimy ana 
offensive. Breasts swollen and inflamed ; or flaccid 
and empty. Constipation or slimy diarrhoea. Lili- 
enthal says, "If Bell, be insufficient try Hyosc." 

Bryonia : High fever, nearly or quite equal over 
the whole body, with great thirst ; sensitive to mo- 
tion, often screaming when moved from side to 
side ; irritable, irascible and moodish ; stitching, 
burning pains in the abdomen, particularly on 
pressure ; cough, splitting headache and red cheeks. 
Lochia suppressed. Perspiration in short spells on 
single parts of the body. Constipation. 

Calendula : After instrmnental labors, when the 
cervix uteri or perineum are lacerated. Where the 
vulva has been long distended and the parts are 
tumefied and lacerated. Chill without thirst, fever 
with thirst, and aching all over. If Arnica seems 
indicated and fails try Calendula and compare also 
carefully Hypericum. 

Carbo veg. : Threatening uterine putrescence ; 
foetid lochia. Collapse in the last stages o'f puer- 
peral disease. In the last extremity a potency of 
Carbo veg. will often bridge a terrible chasm. 



178 AN OBSTETRIC MENTOR. 

Carbolic acid : High fever alternating with 
oft recurring chills of short duration, followed by 
profuse sweat with restlessness ; increased tender- 
ness over the uterine region and right iliac fossa ; 
pulse filiform ; involuntary diarrhceac stools of 
great fcetor : lochia foetid or suppressed ; worse in 
the afternoon j right-sided pains. 

Chamomilla : A fit of anger induced the dis- 
ease ; mammae flaccid and empty ; whitish diar- 
rhoea ; scanty lochia. Abdomen distended and 
sensitive. Colic like labor pains. General heat and 
great thirst. Excessive irritability and impatience. 
(Compare Bry. and Nux.) Urine pale and abundant. 

China : Useful in late stages of puerperal ty- 
phoid, and after cases marked by excessive haemor- 
rhagic (or other) discharges. 

China arsen. : Advised by Dr. Baehr for ex- 
treme prostration, muttering delirium, grasping at 
flecks, involuntary stools. 

Colocynthus : Disease caused by violent cha- 
grin. Severe colicky pains causing her to bend 
double, with great restlessness : feeling in the whole 
abdomen as if the parts were squeezed between 
stones. Delirium alternating with sopor. Hot 
head, red face, glistening eyes, dry heat, hard, full, 
quick pulse. 

ConiUm : Puerperal ovaritis. Aching in the 
uterine region. Vertigo. Intermittent urination. 
Irregular pulse. 

Iodium : Puerperal metritis characterized by a 
low, persistent grade of fever, and feeble pulse. 
Acute pain and inflammation of the breasts de- 
veloped from the uterine trouble. Kali iod. is 
sometimes preferable upon similar indications, 
especially if a syphilitic taint be suspected. 



AN OBSTETRIC MENTOR. 1 79 

Kreasote : Stiches in the vagina, proceeding 
from the abdomen, causing her to start at every pain. 
Uterine putrescence j lochia putrid, excoriating and 
intermittent; stools also putrid ; urine foetid, clouded 
and brown. Abdomen distended and tense like a 
drum : labor-like pains in the abdomen : drawing 
in the upper abdomen extending to the small of the 
back and pressing forward towards the lumbar 
vertebrae, with flushes of heat in the face and pal- 
pitation of the heart. Painful cold sensation in 
the abdomen. Loss of memory ; thinks she is well. 

Lachesis : Unconsciousness with purple coun- 
tenance. Lochia foetid, urine suppressed. Abdomen 
swollen a7id sensitive. She is constantly lifting up the 
bed-clothes because their pressure causes an uneasy 
sensation in the uterine region. Pain in the uterus 
relieved for a time by a flow of blood, but soon 
returning. Aggravation after sleeping. Constipa- 
tion and history of ovarian affections. 

Mercurius vivus : Pueiperal metritis (or peri- 
tonitis especially). Lancinating, boring or pressing 
pains in the uterine and genital regions. Abdomen, 
especially the pit of the stomach, very sensitive. 
Moist, soft tongue, showing the imprint of the teeth. 
Intense thirst and profuse sweat day and night 
without relief. Worse all night, but especially be- 
fore midnight. Bloody slimy diarrhoea. 

Muriatic acid : Puerperal typhoid ; where 
China or China ars. fail. 

Nux vomica : Bruised sensation referred to 
the cervix uteri. Heaviness and burning in the 
genitals and abdomen. Lochia suppressed or too 
profuse and offensive with violent pains in the small 
of the back. Frequent desire to urinate, with scald- 
ing burning pain. Constipation, or rectal irrita- 



l8o AN OBSTETRIC MENTOR. 

bility. Nausea and desire to vomit, or actual emesis. 
Spasmodic pains in the arms and legs which " go 
to sleep." Dull headache, red face, vertigo, dimness 
of sight, ringing in the ears, fainting turns. Aggra- 
vation in the morning. 

Platina : Painful sensitiveness and continual 
pressure in the region of the mons veneris and 
genitals, she cannot bear the touch of the napkin. 
Voluptuous tingling in the abdomen and vulva. 
Profuse, thick, black, bloody lochia. Puerperal 
•ovaritis. 

Phosphoric acid : Puerperal typhoid. Great 
debility ; sinking condition with irregular intermit- 
tent pulse. Profuse sweats. Indifference to every- 
thing, low delirium, dullness of the head. Coldness 
of the extremities. Meteoristic distention of the 
uterus. Dr. J. H. Woodbury says: "With the 
above symptoms I have seen it of most decided 
service, in some cases rescuing patients when in an 
apparently hopeless condition." 

Pulsatilla : Milk and lochia suppressed, or at all 
events abnormal. Towards night more pain, more 
thirst, more despondency, more very severe after- 
pains, with dull, aching pains in the back. Small 
pulse even though the fever be high, causing a 
burning skin, followed by profuse sweat often cool 
and clammy or sticky, with a soft flabby feel of the 
flesh. Some cough towards evening with spitting 
of stringy mucus. Urinates often with some dis- 
position to diarrhoea. Palpitation of the heart with 
trembling of the hands and voice. Sight and hear- 
ing impaired. She starts and twitches in her sleep, 
often moans and awakes somewhat bewildered. 
Has a gnawing feeling in her stomach as if hungry, 
but when she eats her stomach aches and she has 



AN OBSTETRIC MENTOR. 151 

nausea and even vomiting. Abdomen tender to 
touch ; flatulent colicky pains about the umbilicus ; 
pains cutting through the pelvis from back to front. 
Not only foetid flatus from the bowel but also loud 
reports from the uterus, with a feeling of weight, 
pressure and fullness. Dry, burning heat in the 
vagina and uterus with thick offensive discharge 
causing much itching and general irritability. Feet 
jerk and tingle and " go to sleep." She wants them 
rubbed frequently. She lies on her back either 
awake or asleep. Sleep restless and full of dreams ; 
she wakes often much disturbed and is soon asleep 
again. Sweat during sleep. Easily chilled, hands, 
feet, and forehead often icy cold. Says Dr. O. P. 
Baehr, " Its attacks are not violent like those of 
Aeon., Gels., or Verat. virid., but they often creep 
on slowly, mildly and stealthily but surely. . . . 
The changes in a Pulsatilla puerperal fever are very 
numerous : one hour you may fancy your patient 
better, when in another she is alarmingly prostrated. 
She may sleep and eat, talk and sit up in bed one 
day, and need the doctor three times the next. 
Stick to Puis., and all will be right." 

Rhus tox : Puerperal peritonitis or typhoid. 
Cool skin and high pulse, or low pulse and hot 
skin ; apathetic and stupid ; lochia offensive and 
intermittent ; milk vanishes ; restlessness ; she 
changes position often which affords a few moments' 
relief ; loss of power of the lower extremities. 
Tongue dry, with red tip. 

Sabina : Puerperal ovaritis. 

Salicylic acid : Uterine putrescence ; high 
fever and excessive sensitiveness to jar or motion. 
Rheumatic tendencies ; compare with Carb. ac. and 
Kreas. 



l82 an obstetric mentor. 

Sec ale : Uterine putrescence ; broivnish, offen- 
sive lochia. Burning fever interrupted by shaking 
chills ; small sometimes intermitting pulse ; ab- 
domen distended but not very painful ; pain at the 
pit of the stomach, vomiting of decomposed mat- 
ter ; offensive diarrhoea ; urine suppressed ; bed- 
sores which tend to become gangrenous. Quiet 
delirium, or wild desire to get out of bed. Terrible 
forcing, bearing down after pain. 

Stramonium : Mental excitement and delusions 
very marked ; thinks rats and mice are under the 
bed and looks to find them ; thinks that she lies 
doubled or cross-wise in the bed ; the head is 
jerked up from the pillow and falls back again. Pu- 
erperal metritis. 

Sulphur : Vulva excoriated by the discharges ; 
after improvement (under other remedies) she 
grows worse again. 

Terebinthina : General languor and weakness ; 
high fever, quick pulse with frequent headache and 
a sensation of dryness of the mucous surfaces; 
excessive meteoristic distention of the abdomen j fre- 
quent colic and rumbling in the bowels. Strangury 
or complete suppression of urine. 

Ustilago : Urine and stools dark and offensive ; 
aching of the womb ; lochia profuse, dark, bloody 
and offensive. 

Veratrum viride : Sudden attack (often ab- 
solutely instantaneous) of a chill or nervous chilli- 
ness and shuddering, with nausea ; followed by 
an intense fever, characterized by a full, hard, 
quick bounding pulse and much oppression in the 
chest ; congestion of the lungs and the head ; 
spasmodic twitching and restlessness ; sudden sup- 
pression of the lochia ; sudden severity is the char- 



AN OBSTETRIC MENTOR. 1 83 

acteristic of Veratrum viride ; profuse cool long- 
lasting sweat ; delirium. This is certainly among 
the first drugs to be considered in every case of 
puerperal fever. 

The following drugs are also advised : Canth., 
Coff., Gels., Hyosc., Kali chlo. 

Dr. Marsden and Dr. Eaton place great confid- 
ence in the methodical use of Quinine, in conjunc- 
tion with other drugs. The former advises the 1 / 10 
trituration and the latter 2 grains of the crude drug. 

Hygienic : Observe excessive cleanliness ; let 
the patient be kept clean by sponging with hot 
water and alcohol ; frequent changes of clothing, 
well aired and hot from the stove. Secure free 
ventilation at all hazards ; allow cooling drinks 
freely, of which milk is the chief : no stimulants. 

For spurious peritonitis : Verat. viride is the 
chief remedy and usually the only one needed (com- 
pare the preceding indications). Should it fail 
however, 

Compare also : 1. Aeon., Actea, Bell., Gels. 
Hyosc, Ign., Nux v., Opium, Puis., Spig., Zinc. 
val. 

2. Cham., Coff., Coloc, Cupr., Ipec, Kali carb., 
Lach., Phos. 

Puerperal Insanity. 

For mania : 1. Actea, Bell., Hyosc, Plat, 
Strain., Sulph., Verat. alb., Verat. viride. 

2. Aeon., Ars., Cann. indie, China, Gelsem., 
Glon., Petrol. 

For melancholia : 1. Actea, Aur., Helon., Kali 
carb., Verat. alb. 

2. Ign., Lach, Lilium, Puis., Zinc. 

Aconitum : After fright or anger ; fear of 



184 AN OBSTETRIC MENTOR. 

death, of strangers, of getting up ; intense anxiety ; 
reproaches others for mere trifles. 

Actea : Declares she will go crazy : a terrible 
gloom oppresses her and she is suspicious, indiffer- 
ent, taciturn, and tends to suicide ; irritable, the 
least thing makes her angry and destructive. 

Arsenicum : Weakness with nausea ; alterna- 
tions of hot and cold. Intense restlessness with 
rapid emanciation. Anczmic patients with suicidal 
tendencies. A sagacious alienist remarks " Aurum is 
often given in melancholia where Arsenicum is the 
remedy." 

Aurum : Very unhappy ; continual thought of 
suicide ; memory and intellect weak ; sleepless day 
and night ; prays all the time and says she is not fit 
for this world, which idea leads to suicidal broodings. 

^Belladonna : Desire to escape or hide herself ; 
paroxysms of rage or fury. Sleepless nights, fear 
of ghosts. Desires others to kill her that she may 
be out of her misery ; moaning ; merry, but quar- 
relsome ; spits and bites at any one ; starts as if 
affrighted at any approach, or else imbecile stupor ; 
she acts as if stunned ; the former (active) condi- 
tion means Bell, high, the latter (depressed mental- 
ity) requires a low dilution to reach it. 

* Hyosc, Bell., and Stram. should be studied together, and 
may almost be said to represent three stages or phases of a 
single pathological condition. Under Hyosc, we find a con- 
gestive, or almost inflammatory condition, which produces 
loquicity and mania in fits of short duration. In Bell., we 
see the continued delirious rage and fury of on active inflam- 
mation at its height ; or the stupor of the post-inflammatory 
paralysis, while in Stram., the long continued cerebral lesion 
has produced a mania, which, in the violence of its unreasoning 
mental choros, more nearly resembles hydrophobia than any 
thing else. 



AN OBSTETRIC MENTOR. 185 

Cannabis indic: Catalepsy; she imagines she 
is the Queen or the Virgin Mary ; distances and 
times exaggerated, and she becomes violently ma- 
niacal if left in darkness. 

China : Anaemia and nervous irritability from 
loss of blood ; delirium with illusions and halluci- 
nations ; anxiety and longing for death, or else in- 
difference and apathy. 

Gelsemium : Stupid as if intoxicated, with low 
muttering delirium ; sees demons ; fright, despond- 
ency ; passive congestion. 

Glonoine : Stupidity and muttering delirium. 

Helonias : Melancholia with sub-involution, 
uterine displacement, atonic leucorrhcea, etc. 

* Hyoscyamus : Loquacity and jolly mania with 
transient fits of frenzy. She does not know her 
relatives (Continually calls for those who stand 
beside her.) Complains of being poisoned and will 
neither eat, drink nor take medicine on that account ; 
complete loss of sense and modesty ; she throws off 
the bedding and other clothing and desires to go 
naked ; she calls for her husband to come and go to 
bed with her ; this drug is second to none in puer- 
peral mania. 

Ignatia : Persistent tearful or silent melancholy; 
she desires solitude ; when the child is still born or 
dies soon after birth. 

Kali garb.: Great sadness, weeps much and is 
afraid that she is going to die ; absence of mind, 
seems at a loss to know how to begin to say 
or do what she wishes ; makes several at- 
tempts but is finally compelled to give it up ; 
flatulently distended abdomen ; thirst or restless- 
ness. 

Lachesis : Mania with loquacity ; more often 



l86 AN OBSTETRIC MENTOR. 

melancholy with delusions that she is dead, or about 
to die ; follows Ars. or Bapt. well. 

Lilium : Religious mania, with hurried speech 
and actions, and anxiety about her salvation ; irrit- 
able and impatient ; melancholy with great appre- 
hension. Left-sided affections, particularly the 
ovary. Active uterine congestion with palpitation 
of the heart. 

Petroleum : Strange delusions, thinks there is 
another baby in bed with her requiring attention ; 
or thinks she has a third leg or arm ; sharp pains 
shooting up the dorsal spine into the occiput. 

Platina : Voluptuous crawling up and about the 
genitals ; very haughty, looks down very disdain- 
fully upon her attendants ; black tarry discharge 
from the vagina. 

Pulsatilla : Sad, weeping mood yet yields 
readily to persuasion and smiles even through her 
tears ; taciturn. When closing her eyes sees pictures 
and all sorts of strange sights and hears operatic 
airs ; difficult breathing after slight emotions. 

* Stramonium : Nymphomania with obscene ges- 
tures and acts (compare Hyosc, Bell., and Platina) ; 
desires light and company, much worse in darkness 
and solitude (also Cann. indie.) very loquacious in 
prayerful beseeching language; face red and bloated. 
Distorted visual hallucinations ; thinks she sees ver- 
min in the room and under the bed ; familiar ob- 
jects terrify her. 

Sulphur : Religious melancholy with despair of 
her own salvation and indifference to the lot of 
others. Forgets the names and words she would 
like to use ; obstinacy, dislikes to have any one near 
her ; flushes of heat, weak faint spells and cold feet ; 
light sleep. She arranges her clothing and hair in 



AN OBSTETRIC MENTOR. 187 

a most fantastic manner and delights in grotesque 
apparel. Happiness is supposed to be a sulphur 
characteristic, but we have not found it confirmed 
in puerperal insanity. 

Veratrum album : Nymphomania with desire 
to embrace every body (even inanimate objects, 
compare Hyosc.), and desire to tear her clothes 
with lasciviousness ; religious melancholy with self- 
condemnation ; desire for cold water and other cool 
refreshing things ; cold sweat on the forehead. 

Veratrum viride : Puerperal mania after the 
convulsions which it accompanied have ceased. 
Hard, full, quick pulse. Silent and suspicious and 
sleepless ; both the Veratrums are noble remedies 
for puerperal mania and should be carefully com- 
pared with Bell., Hyosc, Platina and Stram. 

Zincum : Melancholy, fear of thieves, demons 
and other frightful figures ; weakness of mind, re- 
peats all questions before replying ; cannot keep 
her feet still, they are in constant motion. 

Hygienic : Rest and repose of the body are es- 
sential to the cure, and it is a great mistake to allow 
the patient to run about the apartment even ; much 
less should she roam the house. She may be secured 
so as to prevent this, and all chance of self-violence in 
the following manner : Stand her (and if necessary 
hold her) upon the floor while an attendant winds her 
up in sheets, beginning at the feet and leaving her arms 
free, the patient (and her bandaging) forming a sort 
of cocoon. Now the arms may be secured to the 
sides loosely and the patient likewise bound down 
to the bed. If it seems undesirable to move the 
patient from the bed, the restraint may be applied 
as follows : The patient lying on one side of the 
bed, spread a strong sheet upon the other. Place the. 



1 88 AN OBSTETRIC MENTOR. 

patient upon the sheet and while attendants hold 
her arms by her sides and her legs and feet together 
down straight in the bed, wrap her up snugly by 
rolling her gently in the sheet and fasten the edges 
securely with safety pins. 

Many patients are so quieted by this " cocoon- 
ing " that the binding to the bed is unneces- 
sary. This method secures an easy and humane 
restraint which husbands the patient's strength and 
vitality. And so soon as a disposition to be quiet 
is evinced the restraint should be removed, being 
promptly restored when a fresh outbreak recurs. In 
>every case, the patient must be daily cleansed with 
a hot alcohol and water bath, and all soiled clothing 
removed. At the same time seclusion must be in- 
sisted upon j admit no one to a maniac save the 
physician and necessary attendants and when re- 
covery dawns be not over hasty to relax this rule. 

The diet should be liberal, eggs, milk and beef- 
tea the chief ; since anaemia nearly always marks 
these cases and the violence of the mental activity 
(which we cannot restrain as we do the physical) is 
like a consuming fire which if not furnished fuel 
feeds upon the already impoverished system. Some 
think the sleeplessness of the anaemic may be re- 
lieved by stimulants, but we avoid their use. 

While it is not wise to irritate by undue seventy 
and unnecessary exactions, never yield any impor- 
tant point : but gently, quietly and persistently 
carry out what is for the patient's good. We have 
given a teaspoonful of medicine twenty times 
within as many minutes to a patient who spat it out 
and finally carried the point and saw it swallowed. 

During the height of the disease as well as in con- 
valescence look sharply after all the organs and 



AN OBSTETRIC MENTOR. 189 

functions of the body. See to it that the stomach, 
liver, kidneys, bladder, uterus, and bowels are not 
widely deviating from the normal. If the system 
be in an intense state, so to speak, decomposition is 
very rapid and the bowels should move every forty- 
eight hours at longest, being aided by injections if 
necessary. 

Convalescence established, protect your patient 
carefully from exposure to anything which will re- 
call her delusions ; be cautious about diet, exercise 
and company ; let her have a change of scene if 
possible. Finally one remedy cures rarely ; more 
often a nice sequence of drugs is necessary. The 
following scheme of drug study is suggested first y 
fever remedies, second, blood remedies, third, veg- 
etative remedies, fourth, nerve remedies. Should 
the mental symptoms not seem to give the picture,, 
examine carefully the physical status. 

Phlegmasia Alba Dolens. 

Compare : i. Am., Bell., Bry., Hamam., Kali 
carb., Nux v., Pulsat., Rhus. tox. 

2. Ant. crud., Apis, Ars., Calc. carb., Carbol. ac, 
China, Hep., Iod., Lye, Merc, sol., Secale, Sepia, 
Sil., Sulph. 

Antimonium crud. : Enormous swelling in a 
chronic state. Red lines of absorbents traceable 
on the skin. Disposition to dry gangrene. 

Apis : Fever, restlessness, and tossing to and 
fro without relief. No thirst. Urine scanty or 
suppressed. Whitish transparent swelling. Sting- 
ing or sharp plunging pains. 

Arnica : Terribly sore, bruised, aching sensation 
in the inguinal and femoral regions beginning very 
soon after labor. 



190 AN OBSTETRIC MENTOR. 

Arsenicum : Great restlessness and every motion 
produces a sensation of exhaustion. Thirst for 
small drinks frequently. Cold, wants to be covered 
up warm. Burning pains, swelling, pale and oede- 
matous. 

Belladonna: Cutting pains and heaviness in 
the thighs, hypogastrium and sexual parts. The 
least jar of the bed is painful. Fever with thirst. 
Cannot bear to be touched. Moaning and sleepless- 
ness. Red face and eyes. Cannot bear the least 
light or noise. 

Bryonia : Drawing or lancinating pains from 
the hip to the foot : aggravation from touch or 
the least motion. Copious perspiration without re- 
lief. Pulling sensation in the abdomen extending 
down the leg as if the menses would appear. Dry 
lips and mouth and thirst for copious draughts of 
cold water. Pale, pink swelling of the leg. Aggra- 
vation in the evening and early part of the night. 

Calcarea carb. : White swelling of the foot and 
leg with sensation of coldness as if covered with a 
damp cloth. Milk suppressed and general cold- 
ness. 

Carbolic acid : Foetid suppuration, exhaustion, 
right side especially. 

China : Great debility, a cachectic condition of 
the system with tumefaction of the limb. 

Hamamelis : We have no special indications 
for this twin brother to Arnica, but clinical experi- 
ence points to it as the chief drug in this trying 
disease. We use internally and externally, and 
have never seen suppuration where it was applied 
in the beginning of the disorder. 

Hepar : Where suppuration is inevitable and 
profuse. 



AN OBSTETRIC MENTOR. 191 

Iodine : In obstinate cases marked by a scrofu- 
lous diathesis. 

Kali carb. : Stitching and shooting pains in the 
swollen foot and leg and in the abdomen, which is 
flatulently distended. Distressing pain in the back 
extending down into the glutei muscles. Restless- 
ness, with tossing and thirst. 

Lycopodium : Swollen foot and leg ; the saphena 
vein is swollen very large and is tender and can be 
distinctly traced. Loud rumbling of flatulence in 
the abdomen. Red sand in the urine, backache, better 
after micturition. Restless and tossing at night. 

Mercurius sol. : After Bell, or Bry. When 
suppuration threatens or is present. Hectic fever. 
It promotes absorption. 

Nux vomica : Red swelling of the leg with dark 
painful spots ; a powerless, bruised sensation of 
the leg and low down in the abdomen, with frequent 
urging to urinate and defecate. Loss of appetite. 
Aggravation after three o'clock in the morning. 
Great depression and irritability. 

Pulsatilla : Pale swelling of the foot and 
limb, with pains in the limb and hypogastrium. 
Suppression of milk and lochia. Thirstlessness. 
Offensive, clammy taste in the mouth after sleeping. 
She craves fresh, cool air. This drug is second only 
to Hamam. in this disorder. 

Rhus tox. : At the very outset there is loss of 
power to use the limb ; she cannot draw it up. 
A red streak marks the course of the saphena vein. 
Great restlessness, every change affording but a bit 
of relief. Worse after midnight and after wetting 
the part ; wants warm covering. 

Secale : Numb cold limbs. Diarrhoea. A 
stupid condition of the brain. 



I92 AN OBSTETRIC MENTOR. 

Sepia : Where chronic congestion or inflamma- 
tion of the uterus co-exist. 

Silicea : When suppuration leaves an ulcerative 
surface, with scanty discharge. 

Sulphur : Papular eruptions over the leg and 
whole body. Great numbness, heaviness and want 
of power in the limb. 

Hygienic : Keep cheerful and do not let your 
patient get disheartened. If doing fairly well, let 
well enough alone, and keep the affected parts 
wrapped up in flannel. If the swelling increase 
with alarming rapidity apply flannels wrung out 
in hot water medicated with the indicated drug 
(usually Hamam.) : let these be renewed as often 
as they get cool. If the swelling " points" and 
absolutely fluctuates and yet does not discharge, 
open it : under any other conditions the use of a 
knife is indefensible. When the swelling becomes 
an abscess or ulceration it loses its distinctive char- 
acter and should be treated accordingly. 

Pelvic Cellulitis. 

First Stage. (Congestive). 1. Aeon., Arn., Bell., 
Bry., Con., Merc, sol., Verat. viride. 2. Actea, 
Ars., Bar. carb., Kali carb., Plat.. Secale. 

Second Stage. (Effusive). 1. Apis, Ars., Bry., 
Rhus tox., Tart. em. 2. Canth., Colch., Digit., 
Helleb., Merc, sol., Sulph. 

Third Stage. (Suppurative). 1. Hepar., Merc. 
sol., Si/. 2. Calc. carb., Sulphur. 

The principal remedies are recognized by these : 

Pa7-ticular Indications. 

Aconitum : The drug in the beginning when the 
disease arises from a cold ; pressure on the crusal 



AN OBSTETRIC MENTOR. 1 93 

nerve or its branches. Ludlam says, give low and 
frequently. It is only useful in the first stage. 

Arnica : After a long, severe or instrumental 
labor, and when the pain is excessive and the swel- 
ling little or nothing. Hypericum should also be 
considered in such a case. Like Aconite Arnica is 
chiefly useful in the first stage : Ludlam advises 
their alternation. 

Apis: This is the great remedy to promote ab- 
sorption, for which purpose it is only equaled by 
Tartar emetic, and finds its use in the second stage. 

Belladonna : Erysipelatous cellulitis. Low 
grade of fever with many nervous symptoms, head- 
ache, delirium, photophobia, etc. It is a correlative 
to Aconite in the first stage. 

Bryonia : The swelling is extremely sensitive to 
touch and she cannot bear contact or motion. First 
stage. 

Conium : Prominent swelling arising suddenly 
after a hard long instrumental labor, or after a 
blow or fall, or after rigid os uteri. Leucorrhcea of 
whitish or bloody mucus, very acrid and corrosive 
with pain in the small of the back. Study also 
Arnica and Hypericum, in the first stage. 

Silicea : When the suppuration is too long con- 
tinued, the ulcer becomes foul and the pus degen- 
erate. Third stage. 

Tartar emetic : Is the great absorbent of inflam- 
matory products in the pelvis and must be used 
low, rarely and persistently to secure its best effect 
in the second stage. 

Veratrum viride : This is probably the chief 
remedy for the first stage and will often abort the 
incipient inflammation. Suppression of milk and 
lochia. Intense nervous excitement, even to delirium 



194 AN OBSTETRIC MENTOR. 

and mania. Vesical, rectal, and uterine tenesmus. 
Severe pains in (and tenderness of) the hypogas- 
trium. Abdominal tympanites. Hard, full, frequent 
pulse. Cases where the indications seem to call for 
both Aconite and Belladonna usually need Veratrum 
viride. 

Hygienic : During the first stage a light diet of 
milk and milk foods is wise ; but so soon as the 
original congestive onset is passed and we deal with 
a product of inflammation, a more liberal and stim- 
ulating diet is essential. Do not use alcohol how- 
ever : trust to milk or other good strong food. 
What was said of the knife in the preceding section 
applies here. 



CHAPTER XL 

Miliary Fever. Lacteal Variations. Milk 
Fever. Mastitis. Sore Nipples. 
For Miliaria. 

i. Aeon., Bry., Ipec, Merc. sol. 2. Ars., Bell., 
Valeriana. 

Aconitum : High fever and red (or white ?) 
rash. This drug will often break up this little 
plague if given early. 

Arsenicum : White miliaria with no (or little) 
heat, but excessive restlessness and thirst. 

Belladonna : Very red fine hot rash. Turgid 
tongue, papillae. 

Bryonia : Usually the only remedy needed when, 
after the fever subsiding, the rash and itching con- 
tinue. 

Ipecacuanha : Excessive sweatings and inces- 
sant nausea. 

Mercurius sol.: Persistent pustular headed 
eruption continuing after the fever. (Compare 
Juglans, cin. and tart, em.) 

Valeriana : Eruption with watering eyes, op- 
pressed chest, diarrhoea, bad taste and smell, trem- 
ulousness, creeping chilliness and occasional sweats. 

Hygienic : For deliverance from this harmless 
torment we may obtain fervent blessings. Keep the 
room cool and do not allow too warm or heavy bed- 
ding. Grateful relief is sometimes obtained by 



I96 AN OBSTETRIC MENTOR. 

spongings with very weak solutions of Acetic or 
Phosphoric acid and water. 

For Sore Nipples. 

1. Ar^i., Calend., Castor equor., Ham., Phyt. 

2. Agar., Calc. carb., Cham., Croton tig., Graph.,. 
Lye, Merc, sol., Phos., Puis., Sep., Sil., Sulph. 

Agaricus : Red, burning, itching nipples ; women 
who have chillblains. 

Arnica : Nipples feel sore as if bruised; often 
indicated and cures soon when early applied ; use 
internally and externally. 

Calc area carb.: An ulcer on the nipple dis- 
charging pus. 

Calendula : The remedy for a cracked or fls- 
sured nipple : use internally and externally. 

Castor equorum : Neglected cases where the 
nipple is nearly ulcerated off ; it only hangs as it 
were by small strings. Use internally and also ex- 
ternally, diluted one half with glycerine or sweet 
oil. From this treatment we have seen excellent 
results. 

Chamomilla : Nipples inflamed and very tender, 
she can hardly endure the child's nursing ; in fact, 
she* is very irritable, cross and impatient, and says 
she can't stand it and won't stand it. 

Croton tiglium : Every time the child draws at 
the nipple, a pain runs through to the scapula on 
that side, which is excruciating. The nipples are 
very sore and have an eczematous appearance. 

Graphites : Little vesicles on the nipples. The 
nipple oozes out a thick glutinous fluid which forms a 
crust, which is removed by nursing only to form 
again. 1 



AN OBSTETRIC MENTOR. 197 

Hamamelis : Where soreness and tenderness are 
the chief characteristics and Arnica fails. 

Lycopodium : The nipples bleed and are very 
sore ; the child draws so much blood that he vomits 
it up. 

Mercurius sol.: The nipples feel very raw and 
sore. Gums sensitive, teeth sore and leave their 
dents upon the tongue ; enlarged cervical glands. 

Phosphorus : The nipples are hot and sore and 
the abdomen feels weak and empty. Much heat in 
the lower part of the back across the kidney region. 

Phytolacca: Sore fissured nipples. Intense suf- 
fering on putting the child to the breast ; the pain 
seems to radiate from the nipple over the whole 
body. 

Pulsatilla : The pain from nursing extends 
into the chest, up to the neck and down the back ; 
often changes from place to place. 

Sepia : The nipples are sore and deeply cracked 
across the crown in various places. 

Silicea : The nipple is sore and tender, and 
ulcerates very easily. 

Sulphur : After nursing the nipple smarts and 
burns much ; it is chapped and bleeding about the 
base. 

Hygienic and topical : If proper remedies are 
given for abnormal conditions of the breast during 
pregnancy, and they are daily washed in cold water, 
and the nipples hardened, all trouble will be eas- 
ily avoided. Guernsey advises "to dissolve a few 
globules of the same remedy (as is given internally) 
in water or brandy and water and apply to the nip- 
ple after nursing." We confess to the best results 
with Arnica and Hamamelis internally and exter- 
nally in simple soreness, while a cracked nipple is 



I90 AN OBSTETRIC MENTOR. 

as surely cured by Calendula as an ulcerated one is 
by the dilute castor oil. An aphthous nipple will 
need a Hydrastis glycerole ; which failing, a dilu- 
tion of Arsenicum locally used sometimes affords 
magic relief. Dr. Eaton thinks that the Basilicon 
oint77ient excels all other applications for a fissured 
nipple. Ludlam advises for simple abrasion arrow 
root, cornstarch, gum arabic, borax and white sugar ; 
to the first, white oxide of zinc may be added, a 
drachm to an ounce. For aphthous ulceration in 
addition to Hydrastis, Baptisia and the mineral 
acids. For fissures he mentions the acids, elastic 
Collodion, a glycerole of gum benzoine and the 
yolk of an egg, four parts by weight to five of 
glycerine: A good nipple shield is a great help. 

Milk Fever. 

Rarely requires any treatment if the child 
is put to the breast within a few hours after 
birth and taught to nurse. If drugs seem necessary, 
compare : Aeon., Arn., Bell., Bry., Coff., Rhus tox. 3 
Verat. virid. 

Lacteal Variations. 

No Milk Secreted : Agnus cast, Secale, Urtica 
urens. 

Milk Scanty : 1. Agnus cast., Asafcet., * Borax. 2. 
Bry., Calc. carb., China, Merc, sol., Phos. ac, Pul- 
sat. 

Milk Suppressed : 1. Aeon., Caust., Dulc> Puis. 
2. Cham., Phyt., Verat virid. 

Milk, Too Profuse : Acetic ac, Calc. carb., Mentha 
pip., Pul., Phyt., Uron. nit. 

* Low Potency. 



AN OBSTETRIC MENTOR. 199 

Galactorrhea : Bell., * Borax, Bry., Calc. carb., 
China, Con., Phos., Puis., Rhus tox., Stram. 

Cramps in Stomach (from nursing) : Carbo. an., 
Carbo veg., China, Phos. 

" Goneness " in Stomach (from nursing) : Carbo. 
an., Hydrast., Ign., Oleander, Sepia. 

Milk, Acid : Calcarea phosphorica. 

Milk, Bitter and Yellow : Rheum. 

Milk, Blueish : Lachesis. 

Milk Tastes Badly : Borax, Calc. phos., Merc, 
sol., Rheum. 

Milk, Tastes Salt : Calc. phos., Carbo. an. 

Milk, Too Thick : Borax. 

Milk, Too Thin : Calc. phos., Carbo an., China, 
Lach., Puis. 

Milk, Watery : Calc. phos., China, Kali b. (and 
stringy), Puis. 

Aconitum : Hot dry skin, much thirst, restless- 
ness and anxiety. The breasts are hot, hard and 
swollen, but contain little or no milk. 

Acetic acid : Milk normal in quality, but 
enormous in quantity. 

Agnus castus : Despairing sadness, frequently 
says she will die. Milk very scanty. 

Asafcetida : Excessive hysterical sensibility of 
the vital organism and the veins unnaturally dis- 
tended. Milk scanty; frequently indicated. 

Belladonna : Spontaneous and excessive flow 
of milk with large swollen, red, heavy breasts, 
cephalic congestion and sleeplessness. 

Borax : For a scanty flow of milk with stitches 
and aching in the breasts which she presses with the 
hand, they are so painful ; give hi a low dilution m 

* High dilution. .^ 



200 AN OBSTETRIC MENTOR. 

While a profuse spontaneous flow or a vitiated se- 
cretion of thick, bad tasting, easy-curdling milk 
calls for a higher dilution. 

Bryonia : Her breasts are stony hard and, 
although swollen, are not red, but tormented by ten- 
sive, burning, sttching pains, and afford but little 
milk. Galactorrhea. 

Calcarea carb.: Mammae distended but the milk 
is scanty, and there seems a want of vital activity to 
bring it forward. Also profuse spontaneous milk 
flow. 

Calcarea phosphorica : Milk scanty, thick, 
salt, acid ; pains and burning in the mammae. 

Carbo animalis : Milk thin and salt ; nodosities 
in the mammae ; nursing causes stitching pains ; 
gastric cramps from nursing. 

Carbo veg. : Gastric dyspepsia and gastralgia 
from prolonged nursing, or nursing continued after 
a new conception. 

Causticum : Milk diminished or suppressed by 
over-fatigue, night watching and anxiety ; delicate 
light complexioned women. 

Chamomilla : Milk suppressed by anger; 
breasts very tender ; she is restless, fretful, cross 
and passionate. Such an one said : " I can't en- 
dure it and I wont." Cham, soon relieved. 

China: Weakness from flooding or profuse lochia. 
Aggravation every other day. Milk scanty, thin 
and watery. Cramps in stomach and debility from 
prolonged lactation. 

Dulcamara : Milk suppressed (or fails to be se- 
creted ?) from exposure to the cold and damp air : 
mammae swollen, painless, inactive, but their cuticle 
itches, and she is subject to eruptions caused by 
cold. 



AN OBSTETRIC MENTOR. 201 

Kali bich. : The milk has the appearance of 
stringy white masses and water. 

Lachesis : The milk is blue and thin. She is 
very desolate and sad and unhappy. 

Merc. sol. : Milk scanty and tastes badly ; 
mammae. swollen and hard and feel raw and sore. 

Mentha pip. : Breasts swollen, engorged and 
full of very painful little lumps. Milk profuse. 

Phosphoric acid : Milk scanty, with great de- 
bility and great apathy. 

Pulsatilla : One of our best milk prompters 
for mild, tearful women apparently in a good con- 
dition, who have no milk. Or the breasts may be 
much swollen, and she full of erratic rheumatic 
pains. Milk thin and watery and the true milk 
globule almost entirely absent. Fever, but no 
thirst. 

Rheum.: Milk tastes badly (bitter) and is very 
yellow. Mother and child have painful sour diar- 
rhoea. 

Secale : After exhausting haemorrhages and ex- 
cessive after pains in thin, scrawny women, little or 
no milk flows into the breasts, which sting terribly. 

Urtica urea : Milk very scanty, or fails en- 
tirely to be secreted. 

Mastitis Puerperalis. 

* Study, i. Aeon., Bell., Bry., Graph., Hepar y 
Mentha pip., Phosph., Phyt., Sil. 2. Acetic ac, 
Apis, Aurum triph., Carbo an., Cham., Cistus, Con., 
Lach., Merc, sol., Rhus tox., Sulph., Verat. viride. 

Acetic acid : Breasts greatly and painfully 
distended ; threatening an abscess. 

* Compare also the remedies under " Sore Nipples " and 
" Lacteal Variations." 



202 AN OBSTETRIC MENTOR. 

Aconitum : A chill followed by fever, etc., 
after exposure to a dry cold air. 

Apis : Hard swelling of the breasts with burn- 
ing, stinging pains, redness and inflammation. 

Aurum triphyllum ; Lumps deep in left breast, 
with aching pains. 

Belladonna : Breasts feel heavy and there are 
red streaks running like radii from a central point 
{usually the nipple) with pulsating pains, headache 
and dullness and stupidity. Right side especially. 

Bryonia : Breasts stony, hard and heavy, hot 
and painful but not very red. She feels sick and 
faint if she moves or is moved even to sitting up in 
bed. Stitching headache, fever, thirst and hot 
skin. This drug is often to be preferred even above 
Aeon, to meet the onset of mastitis, and a perspira- 
tion following its exhibition will justify its use when 
well chosen. Right side. 

Carbo an. : Breasts swollen and red with burn- 
ing, tearing pains. Terrible darting in the breasts 
which arrests her breathing while the child nurses. 
Right side. 

Chamomilla : Breasts inflamed, swollen and 
painful, with burning, lancinating pains. 

Cistus : Inflammation of the breasts from ob- 
struction of the lacteal ducts with sense of fullness 
in the chest. Scrofulous diathesis. Excessive sen- 
sibility to the cold air. Left side. 

Conium : Inflammation (of the left? breast) with 
stitching pains as if from needles. 

Graphites : Old cicatrices from former ulcera- 
tions impede the flow of milk and threaten the form- 
ation of an abscess. Guernsey says : " I have the 

greatest confidence in Graphites has never 

failed me." 



AN OBSTETRIC MENTOR. 203 

Hepar : When suppuration seems inevitable give 
Hepar high ; dull pains in the breast. " Should 
not be given too soon," says Dr. Ostrom, "lest 
suppuration be thereby accelerated" * and need- 
lessly developed, we add — if fluctuation shows a 
very scanty, slow and illy distributed suppuration, or 
a?i extraordinary abundance of pus, give Hepar low 
and often. Right side. 

Lachesis : Bluish, inflamed breasts. Lancinating 
or hammering pains extending down the arm. 
Chills at night and heat by day. 

Mentha pip. : Hard lumps in the breasts which 
are exquisitely tender. Breasts full and caked. 

Merc. sol. : Hot, hard swelling of the breast 
with raw, sore feeling. Chilliness and throbbings 
proclaim suppuration, or abscesses exist which show 
no signs of healing ; sweating without relief. 

Phosphorus : Phlegmonous inflammation of the 
breasts. Red spots or streaks with stitching, cut- 
ting pains. Knotty abscesses or fistulous ulcers, 
or openings, with burning, stinging pains and of- 
fensive watery discharge. Hectic fever and night 
sweats. Left side. One of the best remedies for a 
mammary abscess or ulceration. 

Phytolacca : Chill followed by fever and painful 
engorgement of the breasts j hardness apparent from 
the first. Many hard, painful nodosities. Abscesses 
with large, fistulous, ulcerated openings, filled with 
unhealthy granulations and discharging a watery, 
foetid ichorous pus. Breast caked solid. Exquisite 
pain radiating from the nipple all over the body. 
This drug is homoeopathic to every stage of the 
disorder, and will cure 95$ of all cases if used 

* Treatise on the Breast, p. 156. 



204 AN OBSTETRIC MENTOR. 

early and often, externally and internally in hot 
water, saturating flannel bandages. 

Rhus tox. : Mastitis from getting wet. Breasts 
red and swollen in streaks and painfully distended, 
or cold, empty, yet painful. 

Silicea : After the abscess a fistulous ulcer re- 
mains, discharging a thin, watery, offensive pus. 
The whole breast seems to be discharging away in 
pus, one lobe after another opening into one com- 
mon ulcer ; or there may be several orifices. The 
value of this drug in such cases cannot be over-esti- 
mated. 

Sulphur : Inflammation running in radii from 
the nipple. Profuse suppuration with chilliness in 
the fore part of the day, and heat in the after part. 
Old ulcerations, the breast feels like a raw sore. 
The breast feels hot, burning and stinging. 

Veratrum viride : Mastitis ushered in by in- 
tense continuous fever, hard, full rapid pulse, de- 
lirium, thirst, etc. Breasts being red and erysip- 
elatous. 

Hygienic : Common sense care of the breasts 
during pregnancy and lactation will do much to 
avert this justly dreaded inflammation. Advise the 
pregnant woman to give her breasts an air bath 
every day and to bathe them well at least once 
daily (and twice is better) with as cold water as she 
puts upon her face. The baby born, put it to the 
breast just as soon as the mother has reasonable 
rest from the fatigues of the labor. When the 
mother's hands and face are bathed (after the 
labor) let it always be with cool water, certainly not 
with hot, nor hardly warm. Do not have the hands 
put in it but let the mother wipe her hands and 
face with a sponge or towel wrung out in the c oo 



AN OBSTETRIC MENTOR. 205 

water. Moreover caution all against undue ex- 
posure of the now active and filled or filling glands : 
she should not sit up while in a perspiration to 
nurse the child, but cool off first. After getting up, 
the breasts should be well covered when she goes 
out if the weather be cold. The best device we have 
seen for this purpose is a large piece of silk to cover 
both breasts completely and tuck in well. If de- 
sired two orifices may be cut for the nipples and 
the child nursed without removing this breast pro- 
tector. When seen during the first stages mastitis 
may frequently be aborted by wrapping the affected 
parts up in white flannels wrung out in boiling 
water medicated with whatever drug is indicated 
while the same is given internally, and changed 
frequently so as to keep up a steaming effect. These 
drugs are most often Bryonia, Phosphorus and Phy- 
tolacca, although we may prefer Veratrum viride if 
an erysipelatous redness prevails, or possibly Bella- 
donna or more rarely Rhus tox. 

If suppuration be a certainty, discard fomenta- 
tions and apply poultices, of which the linseed and 
the old-fashioned Indian meal poultice with a tenth 
part of poke root grated in it are best. Very rarely 
will any one poultice serve well many days, and the 
programme must be varied. In tedious cases of 
ulceration after mastitis, we have gotten fine re- 
sults from a soothing poultice by night and a stim- 
ulating ointment (like the basilicon) by day. The 
annoying little sore lumps which are so often the 
forerunners of mastitis, may be removed by very 
frequent rubbing (from base to apex) of the breast 
with a little lump of lard or vaseline the size of a 
walnut, in which three drops of peppermint have 
been thoroughly incorporated, while Mentha pip. 



206 



AN OBSTETRIC MENTOR. 



is given internally. The best breast pump is a hot 
quart bottle fitted to the nipple and cooled gradu- 
ally. For the use of this, the method of opening 
theabscess, etc., etc., we refer the reader to Dr. H. 
I. Ostrom's valuable monograph on the breasts, 
published by Stoddart & Co., Philadelphia. 



ERRATA. 

Page 102, seventh line, read 57 for 67. 

103, fourteenth " " 115 "127. 

120, foot note, " 119 " 157. 

126, " " " 90 " 117. 

161, " " " 136 " 182. 

173, " " add 76. < 
184, " " tenth line, read choas 
for choros. 



INDEX 



PAGE. 

Abdomen, cracking of the skin" of 76, 173 

pains in walls of 86 

pendulous after confinement 173 

soreness of " 173 

Abortion, in general 118 

causes of 123 

discharges in . 119 

times of. 119 

pains in 121 

Adipsia 15 

Affections, changed 112 

After pains 164 

Agued breast 201 

Albuminuria. ... 56 

Albuminurious retinitis 57 

Alvine evacuations 40 

Amaurosis 102 

Amnion, dropsy of 59 

Anorexia 15 

Anuria 54 

Anus, fissure and ulceration of 33 

Aphthae of the vulva 74 

Appetite, excessive, lost, or for various foods and sub- 
stances 15 

Authorities consulted, list of 13 

Asthma 46 

Articulations of pelvis 95 

Aversion, to food in general 24 

to particular foods and drinks ».... 16 

Back, pains in, during pregnancy 91 

" " " abortion 121 

Bathing during pregnancy 116 



208 INDEX. 

Belching 24 

Bladder remedies 67 

Blindness 102 

Borborygmus 40 

Breast, gathering of the 201 

pains in the, during pregnancy 85 

Breath, shortness of 46 

Bulsing 15 

Cellulitis, pelvic 192 

Cephalalgia 78 

Child-bed fever 174 

Chloasma 76 

Chorea no 

Colic, from flatulency 40 

Congestion of the cervix uteri 68 

pulmonary 45 

Constipation during pregnancy . .27, 140 

after confinement 173 

Convulsions 155 

Cough (See Congestion, pulmonary) 47 

Cramps 93 

Deformity, to prevent (See also Fears and Frights) 115 

Desires for various foods and drinks 16 

Diarrhoea, in general 35 

after confinement 173 

painless or painful 40 

Diathesis, to modify 115 

Diet during pregnancv 1 16 

Discharges in abortion 119 

Disgust for food 24 

Dropsy, in general 58 

of the amnion ... 59 

Dyscrasia, to overcome 115 

Dyspnoea 46 

Dystocia 129 

Dysuria 51 

Ears, affections of 100 

Emotions, unusual 112 

Enuresis 53 

Eructations 19 

Exhaustion during or after labor 153 

Eyes, affections of < 102 

Face-ache 78 



INDEX. 209 

Fainting, during and after labor 151 

False pains = 88 

False waters 59 

Fears and frights 113 

Fever, miliary 195 

milk 198 

puerperal 174 

Flatulency, colic from 40 

Fluor albus 73 

Flooding 138 

Foetus, too violent or incessant motions of .- 115 

Gagging 124 

Galactorrhea 199 

Gastric catarrh 35 

Gastric repertory 24 

Haemorrhage during and after abortion 119 

in general, after labor and various kinds of. 138 

Haemorrhoids 30 

Headache 78 

Hearing, loss of 100 

Heartburn 24 

Heart, palpitation of 49 

Hiccoughing 24 

Hour-glass contraction* 136 

Hunger, excessive 15 

without appetite 15 

Hydrorrhcea 59 

Hygiene of pregnancy 116 

Hysteria 105 

Icterus. 27 

Incontinence of urine 53 

Insomnia 103 

Intestinal repertory 40 

Ischuria 54 

Itching of the genitals 74 

Jaundice 27 

Kidney remedies 68 

Labor, difficult 129 

" to prevent 117 

exhaustion during 153 

fainting during 151 

pains of abnormal 129 

premature " 118 



2IO INDEX. 

Lacteal variations 198 

Leucorrhoea 73 

Liver affections 27 

moth 76 

Lochia, variations of 167 

Longing for various foods and substances 17 

Lungs, congestions of. 45 

Mania puerperalis. 183 

Mastitis puerperalis 201 

Mental alienation 112 

Melancholy, puerperal 1 83 

Metritis, puerperal 174 

Micturition, difficult 51 

Miliary fever 195 

Milk, abnormalities of 199 

suppressed or scanty 198 

too profuse 198 

Milk fever 190 

Milk leg :.. 189 

Miscarriage 118 

Morning sickness 19. 

Motion, foetal, too violent or incessant 115 

Myalgia abdominalis . 86 

Nausea (morning sickness) 19 

where felt 24 

Neuralgia (head and face) 79 

Nipples, soreness of 86, 196 

Nursing, complaints from 199 

CEdema of the feet 59 

Odontalgia 79 

Os uteri, rigidity and spasm of 134 

Ovaritis, puerperal 174 

Pains, false 88 

in abdominal walls 86 

in back , 91 

" " in abortion 121 

in breasts 85 

in face 78 

in head 78 

in teeth 79 

in uterus (in abortion) 121 

predominating (in abortion) 119 

Palpitation of the heart 49 



INDEX. 211 

Pelvic articulations . 95 

Pelvic cellulitis 192 

Peritonitis, puerperal 174 

spurious 183 

Phlegmasia alba dolens 189 

Piles 30 

Placenta, retention of 161 

Preface 12 

Prolapsus uteri 69 

Prosopalgia 78 

Pruritus pudendi. 74 

Ptyalism 24 

Puerperal fever 174 

insanity 183 

mania 183 

melancholia 183 

metritis 174 

peritonitis 174 

typhoid 174 

ovaritis 174 

Putrescence, uterine 174 

Rash of lying-in women 195 

Rectum, fissure and ulceration of 33 

Retained, placenta 161 

Retching (empty) 24 

Retention of urine after labor 162 

Retinitis albuminuria .... 57 

Rigid os uteri 134 

Risings into throat 24 

Salivation 24 

Sight, loss of 102 

Sleeplessness 103 

Sore nipples 86, 196 

Stomach troubles 24 

Stools with worms 44 

various kinds of 41 

various odors of 43 

St. Vitus' dance no 

Taste, variations of 17 

Thirst 15 

Thirstlessness 15 

Thirst with aversion to drink 16 

Toothache 79 



INDEX. 



Typhus puerperalis 1 74 

Umbilicus, ulceration of 173 

Ursemia , 56 

Urethra remedies 67 

Urinary concomitants 67 

repertory. 63 

Urination, difficult 51 

too rare or often 66 

Urine, incontinence of 53 

odors of 64 

retention of, after labor 162 

sediments of 65 

suppression and retention of 54 

too much or little 66 

various kinds of 63 

Uterus, congestion of 68 

displacements of 68 

Uterus, putrescence of 174 

Varicoses 96 

Vertigo, repertory 99 

Vomiting (morning sickness) 19 

of various matters 24 

from various causes 25 

times of 25 

after eating and drinking 26 

Whites 73 

Womb, displacements of 69 



MHH 



